PALO ALTO, Calif. -- Two-year-old conjoined twins can finally lead separate lives, after a successful seven-hour surgery by a huge medical team at Stanford's Lucile Packard Hospital.
In a tearful meeting with the media at the hospital's entrance late Tuesday afternoon, Angelina and Angelica's exhausted mother, Ginady Sabuco, said, "I thank God for everything. This is a dream come true."
Pediatric surgeon Gary Hartman said the procedure posed "no significant surprises," and that the greatest risk -- uncontrolled bleeding, while severing the liver -- was averted.
Following the exhaustive operation, the girls were taken to separate recovery rooms -- their first taste of independence since birth.
Born in the Philippines, the girls were joined at the chest and abdomen, with livers, diaphragms, breast bones, chest and abdominal wall muscles fused. They arrived with their mother in the United States at the age of 1 to join their father Fidel, a Hayward, Calif., tech employee with Blue Cross health insurance. The family found Hartman and Lucile Packard on the Internet -- and began a long campaign to get care.
The two growing girls had already encountered growth deformities, said Hartman.
"There were already pretty significant musculoskeletal changes," he said, "changes in the shape of the chest and curvature of the spine." Sedated after surgery, with their breathing supported by respirators, they will be roused on Wednesday. They'll stay in the hospital's Intensive Care Unit for up to a week.
Their separation was aided by careful planning, the doctors noted, a "deep" team of duplicate specialists, and expertise in several new technologies.
The liver, a single fused organ, was cut using a new tool called that cauterizes liver tissue so it does not leak blood or bile while surgeons are cutting, according to chief of pediatric plastic surgery Dr. Peter Lorenz. The device also uses radiofrequency energy and saline to reduce blood loss.
And as the team reached the liver's major vein and artery, doctors were able to clamp and tie each vessel off. This is an exceedingly delicate procedure, said Lorenz, because of the risk of vessel rupture. Any rip or tear could cause massive blood loss -- or introduce air into the vessels, causing an embolism that results in stroke or heart attack.
Their breast bone was split, and a chest muscle severed.
"Nobody got more than anybody else," joked Hartman.
As they recover, the twins will benefit from another new technology, implanted in their chests to seal their wounds. This polymer plate, made by Synethes Inc., is as strong as metal for the first weeks after surgery -- but then softens and dissolves over time, with no rejection by the body. So they don't have to undergo second surgery.
Surgeon Hartman also credited the months of planning with the success.
"We had the resources and the talent. But it's good planning that tells you how to use those resources and talent," he said. "Every department in the hospital has touched these girls."
When they're ready, the twins will go home to San Jose for additional weeks of rehabilitation -- learning to live on their own.
"That's what we live for," said Hartman. "That's why we do what we do."