Twins Being Separated in Marathon Operation
After months of preparation, UCLA surgeons worked all day and night Monday to separate conjoined twins from Guatemala, a so-far successful operation expected to continue into this morning.
“We’ve been in a nervous state, hoping that everything will turn out,” the twins’ father, Wenceslao Quiej-Lopez, said through an interpreter. He joined his wife, Alba Leticia Alvarez, in Los Angeles on Friday night to be with “Las Maritas,” (the little Marias) as he calls them.
Maria Teresa and Maria de Jesus Quiej-Alvarez, who turned 1 in July, are connected at the top of the head and face in opposite directions. They share part of a skull and some brain tissue.
Within days of their birth in the rural village of Aldea Belen, the girls were taken to a hospital five hours away in Guatemala City, where they lived until May, when Healing the Children flew the girls and their mother to Mattel Children’s Hospital at UCLA.
They left for the operating room at 8 a.m. Monday and underwent preparations for surgery until 1:49 p.m., when surgeons made the first incision. By 5:45 p.m., two teams of surgeons working simultaneously had cut two holes in the skull, one near each girl’s ear, and had cut two-thirds of the way around the skull.
By 10 p.m., doctors had successfully clamped several major blood vessels shared by the twins, a crucial step in the separation, and were cautiously optimistic about the operation’s success, hospital spokeswoman Roxanne Moster said.
More than 50 staff members worked on the girls. Anesthesiologists worked in 12-hour shifts. Teams of reconstructive surgeons were followed by neurosurgeons. The doctors expected the entire procedure to continue at least until 2 a.m.
Neurological tests in June suggested that the twins could be separated. However, the reconstructive surgeons were not sure if the girls would have enough skin to close the wound. To increase the amount of available tissue, they implanted a silicone balloon under the girls’ shared scalp. During the next month, physicians injected saline solution into the balloon to stretch the skin.
In addition to separating their fused skulls, surgeons must deal with the fact that each twin has a vein that drains into her sister’s head. By late Monday, neurosurgeons were working to constrict these vessels slowly so their remaining veins could pick up the extra flow.
The physicians have donated their services. UCLA officials hope a fund set up for the twins will cover the remaining costs of the surgery, which they estimate at $1.5 million. Healing the Children has collected about $6,000 as well, said founder Cris Embleton.
The group petitioned for Quiej-Lopez’s visa July 31 and received approval the same day.
“I really desire to be able to enjoy them and be happy, just like other children,” he said, wearing a T-shirt that read: “God Has Been 2 Good 2 Me.”
When he learned about their condition, he said, “I was afraid and shocked and had no idea what was going on. Why did it happen to me? I just had to accept it. Everyone else has normal kids.”
Dr. Jorge Lazareff, the pediatric neurosurgeon coordinating the twins’ care, met with the parents Saturday to go over details of the surgery.
On Sunday, surgeons worked for hours making final plans for the incisions to ensure that the twins will have enough skin to cover the wound.
The little Marias are no longer so little. They have grown about 10% since the initial measurements were taken, adding to the complexity.
On Sunday night, the family and anesthesiologists held a prayer service. Right before the twins were wheeled to the operating room, representatives of Heal the Children, family members and the hospital staff prayed together one last time. The twins played and blew kisses and said “bye.”
Relatives described their mother as nervous but confident. She refused to comment while they waited. The family is staying with relatives.
The date of the surgery has special significance for Embleton. She was inspired to start Healing the Children to help children worldwide with treatable disorders when her adopted daughter, Lori Jo, died Aug. 5, 1974, just before her first birthday. Lori Jo, who was born in South Korea, died of a staph infection.
“It’s special for me to think that on that special day, two little girls will get a new life,” Embleton said. “It’s a sign of hope for me that good things are going to happen.”
