Palo Alto Doctors to Separate Conjoined Twins

For two little girls from the Philippines, the doctors at Packard Children’s Hospital in Palo Alto are a God send.

Conjoined twins Angelica and Angelina Sabuco are relying on the doctors to separate them on Nov. 1.

The surgery comes after months of preparation and planning and it will take six hours alone just to cut the 2-year-olds, who are attached at the chest and abdomen, apart.

"This is a major operation, but we really expect both twins to survive and to do well," said pediatric surgeon Gary Hartman, MD.

Hartman has performed more of these types of surgeries than any other surgeon, according to NBC Bay Area's Marianne Favro, who sat down with the doctor Friday.

The doctor told Favro that the biggest challenge facing the girls would be splitting their liver because the two of them share one and the risk of hemorrhaging is high

The girls and their family now live in San Jose and their mother, Ginady Sabuco, says she has been praying to God since she first found out her children were conjoined when she was seven months pregnant.

"I was asking God: why us, why me?" she said. "I want them to live normally, like other children." said Ginady, explaining the separation. In addition to the obvious psychosocial difficulties,

Despite medical team of 20 physicians and nurses confidence that the two girls will be able to survive the operation, they face many challenges.

Beyond the psychological adjustment to living separate lives, the girls livers that are tightly fused, intestines that touch and joint sternums.

The doctors also had to start using tissue expanders on the girls back in the Spring to help cover the hole that will be left where the doctors separate the two.

Both girls do have separate hearts, though they touch at their tips, and their digestive systems function separately.

The girls will be in intensive care after the surgery and they will be in the hospital for four to five days before being transferred to a regular room for about a week.

Quick facts about separating conjoined twins:

• Most conjoined twins do not survive pregnancy. The occurrence of conjoined twins is estimated to range from 1 in 50,000 births to 1 in 100,000 births worldwide, and the overall survival rate is approximately 25 percent. 
• Angelina and Angelina are classified as Thoraco-omphalopagus; they are joined at the chest and abdomen. Their livers, diaphragms, sterni  (breast bones), chest and abdominal wall muscles are fused.  They have separate hearts, brains, kidneys, stomachs and intestines.
• Separation surgery is performed in the United States about six times per year.
• This will be the sixth separation of conjoined twins for lead surgeon Gary Hartman, MD.
• This is the second set of conjoined twins separated at Packard Children’s. Yurelia and Fiorella Rocha-Arias were separated at the hospital in November 2007.
• Below is video of the two in action: