Family celebrate as conjoined twins' operation is hailed as a success

Published on Wednesday 9 August 2006 00:16

DOCTORS in Utah completed 26 hours of separation and reconstruction surgery yesterday on a pair of four-year-old conjoined twins, who will now face medical challenges and separate lives.

Doctors said they finished surgery on Kendra Herrin about an hour after finishing their work for her sister, Maliyah.

Both girls were moved to the paediatric intensive care unit - where their beds were placed side by side.

The girls had been born fused at the midsection, sharing a liver, a kidney, a pelvis, one set of legs and part of their intestines.

Surgeons at Primary Children's Medical Centre gave each girl one leg, split their liver and intestines and reconstructed their bladders and pelvic rings.

Kendra kept their one functioning kidney, while Maliyah was prepped for kidney dialysis and a transplant within three to six months.

The girls' separation is believed to be the first performed on conjoined twins with a shared kidney, said the hospital's chief of paediatric surgery, Rebecka Meyers.

Ms Meyers said the surgery, while complicated, had not presented any major surprises for the team of six surgeons, two anaesthetists, two urologists, a radiologist and more than 25 nurses and medical technicians.

However, the days ahead will still be tough, she said.

"We have big concerns with both girls," said Ms Meyers. "Maliyah's big concern is her kidney function and her dialysis ... And Kendra's big concern is going to be the coverage of her abdomen."

Surgeons said Kendra had less muscle and tissue for use in closing her abdomen. They planned to use synthetic skin to help solve the problem.

Ms Meyers said Maliyah did not require immediate placement on dialysis, but she expected that to happen within a few days. When she is strong enough for surgery, Maliyah will get a kidney from her mother, Erin.

"For kidney transplant, my time-frame is really dictated more by Maliyah than by me, because there are just benchmarks she has to meet," Ms Meyers said.

The twins are expected to remain in intensive care for about a week and to recover in the hospital for at least a month before doctors can consider sending them home, Ms Meyers said.

Conjoined twins occur about once in every 50,000 to 100,000 births. Only about 20 per cent survive to become viable candidates for separation.

In most instances, conjoined twins undergo separation surgery between the age of six and 12 months, but the girls' shared kidney forced a delay.

Mrs Herrin, 25, broke into tears and fell into the arms of her 26-year-old husband, Jake, when the couple were told the surgery had been successful. Their relatives applauded.

The couple said they were nervous about seeing their daughters separate for the first time.

"I don't know that it's set in yet," said Mr Herrin. "We're not going to feel totally comfortable until they're out of the OR [operating room] and everything's stable."

"And we can hold them," his wife added.

The couple, who also have a six-year-old daughter and twin 14-month-old boys, said they were eager to tell the girls how brave they had been and how proud they had made the family.

Mr Herrin even cracked a joke.

"Most people say, 'You made it through in one piece'," he said. "We can say, 'You guys made it through in two'."

In June, doctors successfully separated conjoined twins Regina and Renata Salinas Fierros. The ten-month-old girls were separated at the Children's Hospital, Los Angeles.

The children were born facing each other, joined from the lower chest to the pelvis.