Surgeons Separate Conjoined Twins

PALO ALTO, Calif. — Angelica and Angelina Sabuco, conjoined twin toddlers born in the Philippines, were separated Tuesday morning during an operation that took more than nine hours at Stanford University’s Children Hospital.  Later in the day, the toddlers had their second phase of the surgery — reconstructing the area where they were connected — at their own operating rooms at Lucile Packard Children’s Hospital.

After two hours, they were moved to the intensive care unit where they are expected to recover for four to five days before being moved to a regular room for another week or so. According to an earlier statement from the hospital, they’ll head home to San Jose to start their lives as two ordinary little girls.

“This is a major operation, but we really expect both twins to survive and to do well,” said lead surgeon, Dr. Gary Hartman, in an earlier statement.

The twin’s mother, Ginady Sabuco, was quoted by the Washington Post, as saying: “This is a dream come true,” when she spoke to the media after the surgery was complete. “Words cannot express how the family feels.”

She was seven months pregnant when she learned her twins were conjoined. “I was asking God: why us, why me?” she said, recalling the day she got the news.  It was especially difficult because her husband, Fidel, was living and working in San Jose while Ginady and their son lived in the Philippines.

The babies, who turned two in August, moved to the United States with their mother last year. They live in San Jose with their parents and 10-year-old brother.  In late 2010, they began meeting with doctors at Packard Children’s Hospital.

The operation is the culmination of several months of complex planning involving specialists from nearly every part of the hospital.

In an earlier hospital statement, the surgical procedure described that “Hartman will make the first incisions in the girls’ skin and muscle, and plastic surgeon Peter Lorenz, MD will cut through their rib bones.  Hartman will separate the girls’ diaphragms and livers, which are firmly adhered along their longest sides. The liver separation will be the riskiest segment of the surgery because it is the most likely to cause blood loss. Hartman will then cut any adhesions between the girls’ bowels,  and cut the last bit of skin that joins the sisters.”

Angelica and Angelina were classified as thoraco-omphalopagus; they are joined at the chest and abdomen. Their livers, diaphragms, sterni (breast bones), chest and abdominal wall muscles are fused.  They have separate hearts, brains, kidneys, stomachs and intestines.

This was Hartman’s sixth operation on conjoined twins.  The most recent set of twins separated at the hospital were Yurelia and Fiorella Rocha-Arias of Costa Rica in November 2007.  They are doing well.

Meanwhile, Ginady and Fidel are preparing the girls for the same ordinary challenges any parent anticipates. “I hope that when they grow up, they go to school, graduate and get stable jobs,” Ginady said. “I want them to have a good future.”

 

PHOTO CREDIT:  Lucile Packard Children Hospital

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