JENNIFER DOBNER - The Associated Press | Posted: Tuesday, August 8, 2006 11:00 pm
SALT LAKE CITY -- Conjoined 4-year-old twins who told their parents they imagined themselves as separate when they got older were successfully separated at a Utah hospital in a 26-hour operation.
Kendra and Maliyah Herrin were heavily sedated Tuesday and breathing with ventilators. They are at high risk for dangerous infections and will be watched carefully, said Dr. Rebecka Meyers, chief pediatric surgeon at Primary Children's Medical Center.
"They are critically ill," Meyers said, who wept talking with reporters a few moments after the surgeries ended.
The North Salt Lake twins were born fused at the midsection, sharing a liver, a kidney, a pelvis, one set of legs and part of their intestines.
The separation and reconstruction operation on the twins began Monday morning and took about 26 hours. The girls, swathed in gauze from chest to pelvis, were then moved to the pediatric intensive care unit, placed in beds side by side.
The twins are expected to remain in intensive care for about a week and recover in the hospital for at least a month before doctors can consider sending them home, Meyers said.
Late Tuesday morning, parents Jake and Erin Herrin had an emotional reunion with their daughters.
"There were happy tears and sad tears," hospital spokeswoman Bonnie Midget said.
Surgeons gave each girl one leg, split the liver and intestines and reconstructed their bladders and their pelvic rings. Kendra kept their one functioning kidney, which was in her torso, while Maliyah was prepped for kidney dialysis and a transplant in three to six months. Her mother is the planned donor.
Doctors also anticipate the girls may need additional reconstructive surgeries later, particularly to be fitted for prosthetic legs.
The Herrins' separation is believed to be the first performed on conjoined twins with a shared kidney, said Meyers.
Pediatric surgeon Dr. Michael Matlak was the first to cradle Kendra after separation, lifting her gently from Maliyah's side on the operating table to move her to a different room for reconstructive surgery.
"It was a great moment," Matlak said later, noting that he nearly tripped on an electrical cord in the OR. "In one sense, she was mine."
Matlak said he feared the gaping separation wound on both girls' bodies would be difficult to close. But tissue expanders placed in the girls weeks ago to grow their skin and muscles, combined with the artful work of plastic surgeons, made the job easier than expected, he said.
"When I was done with the operation and we were getting ready to take (Kendra) to the ICU, I got tears in my eyes, because they looked so good," he said. "I was really relieved because now the twins have got just a good chance."
Conjoined twins occur about once in every 50,000 to 100,000 births. Only about 20 percent survive to become viable candidates for separation. In most instances, conjoined twins undergo separation surgery between ages 6 and 12 months, but the Herrins' kidney forced a delay.
"It was hard to decide whether or not to separate them," said Meyers, who had been consulting with Jake and Erin Herrin even before the girls were born. "I feel good about the decision right now."
The girls had expressed some fear about the surgery, but Jake Herrin said in an earlier interview that separate "was how they saw themselves when they were older."
Jake and Erin Herrin were with family and not speaking to reporters after the surgery. But Monday night after the separation was concluded, they wept and said they were eager to hold their daughters and tell them how brave they had been.
Jake Herrin even cracked a few surgery jokes.
"Most people say, 'You made it through in one piece,' " he said. "We can say, 'You guys made it through in two.' "
On the Net:www.Herrintwins.com
This story appeared in The Daily Herald on page A1.