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Conjoined twins in marathon surgery

/ Source: The Associated Press

Doctors began a marathon operation Wednesday to separate 10-month-old twins who were born joined from the lower chest to the pelvis.

Regina and Renata Salinas Fierros were wheeled into the operating room shortly before 6 a.m. The rare and complex surgery at Childrens Hospital Los Angeles was expected to last 24 hours.

Separating the sisters will “give them independent lives and hopefully a very promising future,” said the lead surgeon, Dr. James Stein.

The identical twins were born facing each other and have separate heads, necks, shoulders, arms, hearts, lungs and legs. They share part of the small intestine and the entire large intestine.

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.

Several physicians from the 80-member team working on the twins 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.

Over several hours, the surgeons will first divide the twins’ breastbone, liver, intestine, bladders, genitalia and pelvis. Then plastic surgeons will reconstruct their chests and pelvis regions.

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 pediatric 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 Aug. 2, 2005, at Los Angeles County-USC Medical Center to Mexican parents who came to the United States 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’ 23-year-old mother, Sonia, said Tuesday that she felt conflicted heading into the operation.

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