Conjoined Twins Successfully Separated
By Tamara Jones
Washington Post Staff Writer
Saturday, June 19, 2004; 6:03 PM
Surgeons successfully separated twins conjoined at the chest and abdomen this afternoon at Children's Hospital in the District.
Cheers and applause broke out in the operating room at about 12:30 p.m. as lead surgeon Gary Hartman snipped the last centimeter of tissue connecting four-month-old Jade and Erin Buckles.
Smiling broadly, the hospital's chief of surgery, Kurt Newman, walked into the day room where the twins' parents, Marine Gunnery Sgt. Kevin Buckles and his wife, Melissa, were waiting anxiously.
"You've now got two babies that are separate and they are both doing well," Newman announced.
Melissa, 30, a high school English teacher, buried her head on her husband's chest and cried with relief.
"I thank you so much," she told Newman.
The actual separation was completed in just two and a half hours. Jade was then rushed to an adjoining operating room.
Various repairs and closure of the massive surgical wound on each girl took an additional three-plus hours. Both babies were recovering in the intensive care unit by late afternoon. They were listed in critical condition.
The separation moved surprisingly fast and without complications, as doctors split the girls' shared liver -- the only human organ that regenerates -- and dealt with what they expected to be the surgery's biggest challenge: Erin's heart, which lies horizontally, with 60 percent of the muscle jutting into Jade's chest.
The emotional day began shortly before 8 a.m., when the babies' weeping mother handed them to the anesthesiologist. Walking back down the hallway with two empty pink and white blankets in her arms, Melissa Buckles encountered another member of the surgical team. "Take care of my girls," she implored.
Jade and Erin, who weighed approximately 18 pounds combined, had been connected from the breastbone to navel and spent every moment of their brief lives face to face.
Other than a large shared liver, their organs were separate, though their diaphragms had been fused.
The girls were delivered Feb. 26 via Caesarian section at the National Naval Medical Center in Bethesda and went home a week later with their parents.
Some two dozen doctors, nurses and specialists were mobilized for the elaborately choreographed operation.
For weeks leading up to the surgery, grids and flow charts were created to map out every detail, from the placement of the first scalpel to the color of ribbons tied to each girl's extremities so surgeons can tell them apart.
Hartman, 56, the pediatric surgeon who heads the team, has successfully separated conjoined twins before.
The surgical team planned to leave Erin's heart exposed rather than risk damage by trying to force it into the baby's too-small thoracic cavity. The protruding portion of the heart will be covered with skin and synthetic material for the time being.
Both girls will need additional corrective or plastic surgery as they mature, doctors said.
Recovery in the hospital's ICU was expected to last anywhere from a few weeks to a few months, depending on complications. Infection poses one of the biggest dangers post-op, since each child will bear a massive surgical wound.
Conjoined twins are the rarest of human births, with only 700 sets born alive in recorded history. Twins fused at the chest and abdomen are the most common, and considered the best candidates for successful separation as long as no major organs are shared.
© 2004 The Washington Post Company