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Conjoined twins separated; prognosis good for sisters

- Associated Press - Tuesday, November 8, 2011

RICHMOND, Va. — Conjoined twin girls from the Dominican Republic were recovering Tuesday at a Virginia hospital after undergoing complicated, nearly daylong surgical procedures to separate them.

Maria and Teresa Tapia, 19 months old, were born joined at the lower chest and abdomen, sharing a liver, pancreas and portion of the small intestine.

A team led by Dr. David Lanning, surgeon-in-chief at Children's Hospital of Richmond at Virginia Commonwealth University, completed a 20-hour surgery on Maria and an 18.5-hour surgery on Teresa.

Dr. Lanning said at a news conference Tuesday the toddlers were in stable condition in the pediatric intensive care unit, and that he expects both to fully recover and "grow up to be healthy, young independent girls."

In several procedures involving six surgeons, the medical team divided the liver, pancreas and other shared organ systems and reconstructed the girls' abdominal walls.

"Everything just went so smoothly over the last 24 hours," Dr. Lanning said.

The girls and their 24-year-old mother, Lisandra Sanatis, arrived in Richmond about two months ago to prepare for the lengthy, intricate surgery. The twins and their family have become celebrities in the Dominican Republic. The country's first lady, Margarita Cedeno de Fernandez, stopped in Richmond on Monday during the surgery to support them.

Ms. Sanatis thanked God, the first lady, Dr. Lanning and many others for helping her daughters, and wept with happiness.

"It was really my dream and thank God it came true," she said through an interpreter.

VCU's first attempt at separating conjoined twins also allowed some of the university's students to use their talents to help the family in unexpected ways.

Students from the Department of Fashion Design and Merchandising created new outfits for the toddlers, an occupational therapist modified a car seat, and a sculpture student created foam models of the twins' bodies so pediatric plastic surgeon Jennifer Rhodes could practice on synthetic skin before the surgery.

The World Pediatric Project, a nonprofit surgical-care provider for children in Central America and the Caribbean, sponsored the twins' medical care, along with the family's stay in the U.S. Dr. Lanning has been a surgical volunteer with the group for several years.

Ms. Sanatis said she has always dreamed of seeing her daughters as separate and independent children. Teresa is more tranquil and Maria is more forceful and tough, she said.

"It may be a little strange at first, but it really is what I wanted," Ms. Sanatis said through an interpreter in an interview before the surgery. "I'm so happy to be able to see them be the individuals they were born to be."

Because of the way the top portion of their small intestines were connected, Maria wasn't able to absorb the nutrition she needed and was about 20 percent smaller than Teresa. Also, nearly 88 percent of the liver's blood flow was routed to Teresa. Dr. Lanning said the disparities would likely have increased unless they were separated.

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