Chile doctors continue battle to separate conjoined twins

2011-12-14 09:08

Santiago – Jessica Navarrete and her husband hugged in the doorway of the surgery ward yesterday morning and kissed their twin babies, Maria Paz and Maria Jose.

Inside, an army of experts was ready to try yet again to work on separating the conjoined twins, this time at the thorax, stomach and pelvic regions.

It would be the seventh operation that the girls would undergo in their 10 months alive. This time, Chileans would be watching on television and the internet.

“Sadness, a lot of sadness,” Navarrete said as the operation got under way at the Luis Calvo Mackenna Hospital in the capital of Santiago.

“Because one as any mother feels fear, but (I have) faith that everything will turn out well and I’m going to see them separated, because this is my dream.

“A miracle from God is what I’m waiting for.”

The twins had lost a lot of blood by yesterday night, but Navarrete and the girls’ father, Roberto Paredes, had issued a call early in the day for the public to donate blood and doctors said later that they had enough to ease the bleeding problem.

By midnight, the twins were two-thirds separated.

“We had to completely separate the chest, and now we are starting the final separation stage of the abdomen and pelvic region,” Francisco Ossandon, head of the surgical team, told reporters.

“So far, things have gone according to form. We have had difficult times, particularly bleeding, but they have been dealt with successfully,” he said.

The operation was expected to last until 4am today for a total of 20 hours.

“They have come out of adverse situations before, and if they have come out from that, how are they going to fall behind now?” Paredes asked.

Perhaps providing some comfort to the parents was the hospital’s history with conjoined twins. Staff there have separated three sets before. A fourth set, however, died during surgery due to cardiac complications.

According to the University of Maryland Medical Center, one out of every 200 000 live births worldwide results in conjoined twins. About 35% survive only one day, while the overall survival rate for the rest is 5% to 25%.

The Chilean twins have presented a particularly difficult challenge to doctors because they share many of the same internal organs and even urinary system.

Hospital director Osvaldo Artaza said the risks of the operation couldn’t be minimised.

“It’s a reality and it’s necessary to be super-transparent in warning that one or the two girls could die,” Artaza said. “But the team ... has committed itself with conviction to try to save the two.”

He was more upbeat around midnight. “The vitality and resilience of the girls has given us momentum and given us strength to continue with what lies ahead,” he told reporters.

Before the procedure started, Ossandon described the twins’ case as the “most complex that has been born in Chile”.

“Never have we faced such a high risk,” Ossandon said.

“We don’t have another option from the perspective of the quality of life and the expectations for life of Maria Jose and Maria Paz.”

Earlier this year, doctors separated the twins’ legs, urinary tracts, pulmonary systems and other parts of their bodies.

Some 100 people were participating in the latest procedure, including 25 surgeons and anesthesiologists.

The twins were born in the Villarrica hospital about 760km from Santiago and have never left medical care, surviving with the aid of an artificial respirator.

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