LA doctors perform surgery to separate conjoined twins

Doctors today began a marathon operation in Los Angeles to separate 10-month-old twins born joined from the lower chest to the pelvis.

Regina and Renata Salinas Fierros were wheeled into the operating room shortly before 6am local time where doctors prepared to give them anaesthesia.

The rare and complex surgery at Childrens Hospital Los Angeles was expected to last 24 hours.

“It’s starting right on time,” said hospital spokesman Steve Rutledge.

The Salinas Fierros twins were born facing each other and have separate heads, necks, shoulders, arms, hearts, lungs and legs. They’re fused from the midsection down, sharing part of the small intestine and the entire large intestine.

Several physicians from the 80-member team previously took part in another conjoined twin separation at the hospital in 2003. But this surgery is more complex because it involves more organ systems.

Doctors expressed confidence that the surgery would be a success. Separating the sisters would “give them independent lives and hopefully a very promising future,” lead surgeon Dr James Stein said yesterday.

Only a few hundred pairs of conjoined twins are born each year worldwide. In the United States, they occur 1 in every 200,000 live births. About 10 per cent of conjoined cases are similar to Regina and Renata.

Over several hours, surgeons will begin separating the twins – first by dividing their breastbone, liver, intestine, bladders, genitalia and pelvis. Then plastic surgeons will reconstruct the babies’ chests, vaginas and pelvises.

Some key decisions will likely be made in the operating room. For example, doctors will have to decide whether to split the shared large intestine or give it to one twin. A person can live without a large intestine.

Following surgery, the girls will be transferred to the paediatric unit where a team of specialists will care for them during the critical 24 to 48 hours after the operation.

Regina and Renata were born with their faces inches apart on August 2, 2005 at Los Angeles County-USC Medical Centre to Mexican parents who went to the US on a tourist visa.

The twins were later transferred to Childrens Hospital where doctors spent months preparing for the separation surgery.

Regina, who was born with one kidney, is the weaker of the two and has trouble gaining weight despite her healthy appetite. But doctors said they have seen cases where the feeble conjoined twin improved after separation.

The girls’ mother, 23-year-old Sonia, said she felt conflicted heading into the operation.

“We feel nervous and anxious, but at the same time very tranquil,” she said.