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Last Updated: Thursday, 5 August, 2004, 10:50 GMT 11:50 UK
Twins 'joined at head' separated
Carl and Clarence Aguirre before their operation
The boys had a number of operations over several months
Two-year-old conjoined twins who were born with the tips of their heads fused together have been successfully separated, doctors say.

Doctors said Carl and Clarence Aguirre, from the Philippines, were "strong and stable".

The marathon operation took place at Children's Hospital at Montefiore Medical Center, New York, on Wednesday.

It was the latest in a series of procedures carried out on the boys over the last 10 months.

Normally, doctors attempt to separate conjoined twins during one long procedure.

The US team chose to carry out several shorter procedures instead in an attempt to shorten the time the twins spent under anaesthetic, reducing the risk of bleeding and injury to the brain.

In previous operations, the boys' skull was opened, their separate-but-touching brains carefully pushed apart and most of their shared blood vessels cut and divided.

Between surgery, the boys were given time to heal and to adapt to their rerouted circulation systems.

Originally, veins near Clarence's brain were doing much of the circulation work for both twins but scans showed dormant veins on Carl's side had "plumped up" and begun working in response to the surgery.

Reconstruction

During this latest operation, doctors completed an incision around their shared skull before teasing apart abutting portions of the boys' brains

Surgeons operate on Carl and Clarence Aguirre
You're now the mother of two boys
Words of surgeon Dr David Staffenberg to the twins' mother after the operation
The twins' head-to-head operating tables were then slightly pulled apart so that the remaining tissue could be separated.

Doctors had to cut and divide the major vein the boys still shared, and separate the remaining area - about an inch and a half across - where the brains were touching -

The twins also shared a dura mater, the membrane that covers the brain, so doctors had to reconstruct membranes for both boys.

The boys skulls will be reconstructed in another operation at a later date.

A hospital spokeswoman explained how Dr David Staffenberg, the boys' plastic surgeon, who led the surgery, broke the news to the twins' mother, Arlene Aguirre, after the operation.

She said: "He got on his knees, took Aguirre's hands and said 'You're now the mother of two boys'."

Mrs Aguirre then burst into tears, she said.


SEE ALSO:
Ethics of separating twins
13 Oct 03  |  Health
Conjoined twins
06 Jul 03  |  Medical notes


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