LA doctors prepare to separate conjoined twins

Doctors in Los Angeles are prepared for a marathon surgery to separate 10-month-old twin girls joined from the chest to the pelvis.

The operation, scheduled to begin early on Wednesday, was expected to last 24 hours. It was considered more complex than other separation surgeries involving conjoined twins because so many organ systems were involved.

Identical twins Regina and Renata Salinas Fierros were born facing each other with separate heads, necks, shoulders, arms, hearts and lungs.
But they were fused from the midsection down, sharing part of the small intestine and the entire large intestine.

Doctors at Children’s hospital Los Angeles said they expected a successful surgery.

“Our goal is to create two very functional children,” said paediatric surgeon Dr James Stein, who leads an 80-member medical team.

Only a few hundred pairs of conjoined twins are born each year worldwide. In the United States, conjoined twins occur once in every 200 000 live births when a single fertilised egg fails to divide completely.

Regina and Renata—born to Mexican parents—are among the rarest cases, representing about 10% of all conjoined twins. Doctors were to first divide the girls’ breastbone, liver, intestine, urinary bladders, genitals and pelvis in a series of a dozen operations. Then a team of plastic surgeons planned to reconstruct the babies’ chests, vaginas and pelvises.

Each twin will have an individual set of organs, but only one could end up having a large intestine depending on how the surgery goes. But that should not affect the other infant’s quality of life, Stein said.

Regina and Renata were born on August 2 2005 at Los Angeles County-USC Medical Centre. They were transferred a day later to the Children’s hospital where doctors closely monitored their condition.

Regina is considered the weaker of the twins and doctors said she has trouble gaining weight despite eating.

To prep them for separation surgery, doctors implanted inflatable balloons under the girls’ skin to stretch it so that it would expand enough to close up the surgical wound.

The girls’ mother, 23-year-old Sonia, said she looked forward to the twins leading separate lives.

“It’s strange to see them together, but I’ll be happy to see them separated,” she said in Spanish.

The Children’s hospital has previously separated five sets of conjoined twins including the 2003 separation of identical nine-month-old girls identified only as Baby A and Baby B from a set of triplets. That operation was also led by Stein. - Sapa-AFP

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