Conjoined California twins survive separation surgery after 18 hours

A set of conjoined twins have survived one of the riskiest separations surgeries ever performed.

Two-year-olds Eva and Erika Sandoval shared most of their lower bodies – a digestive system, a uterus, a liver, a bladder, and a third leg with a seven-toed foot.

On Tuesday at 7am, they were wheeled into the operating theater at Lucile Packard Children’s Hospital Stanford.

After 18 hours, both were in the intensive care unit, with their operation declared a success.

‘The twins did very well,’ lead surgeon Dr. Gary Hartman said on Wednesday. ‘I’m very pleased; this is as good as we could have asked for.’ 

The surgery involved 50 orthopedic, plastic, and urology surgeons – and carryied a 30 percent risk that one or both of them wouldn’t make it. 

Eva, the stronger twin, was in the OR for 17 hours. Erika required another hour of lower body reconstruction before joining her sister in the ward. 

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Before surgery: Eva (left) and Erika (right) pictured arriving at the hospital on Tuesday

During surgery: ‘The twins did very well,’ lead surgeon Dr. Gary Hartman said on Wednesday (pictured during the operation on Tuesday)

Aida, Arturo, and two of their three adult children embrace with joy after the operation

Prior to the surgery, Dr Hartman said Eva would likely keep their bladder, while Erika would get a colostomy bag.

Erika, the weaker twin, was expected to keep their third leg while Eva would get the other two.

Both were expected to be missing vital body parts; and both needed significant reconstruction of their lower bodies.

‘This is a worrisome number because in most cases doctors only perform with a tenth of a percent chance of fatality,’ their parents Aida and Arturo wrote on their Facebook page before the surgery.

‘It’s hard to see the numbers and find comfort on the odds. 

Going to hospital: Arturo, 51, carries the girls as Aida, 46, and their relatives follow en route to Lucille Packard

Before surgery: Erika and Eva look at each other before their operation

Eva and Erika were attached from the sternum to the pelvis. They shared a digestive system, a uterus, a liver, a bladder, and a third leg with a seven-toed foot. Now they are separate

As they grew, they were experiencing more and more health concerns. They were hospitalized with dozens of urinary tract infections and countless cases of dehydration

‘But … from the beginning our girls have superseded the doctors expectations of life and will continue to show us their strength.’

Ahead of the operation, Dr Hartman told the Sacramento Bee the biggest concern was preventing blood loss when severing the liver and the pelvic bone. 

Aida and Arturo made the painstaking decision to attempt separating them last year, as it became clear that with every month more issues arose.

They have been hospitalized with dozens of urinary tract infections and countless cases of dehydration.

And it gets worse with time.   

Their operation is one of the most complicated procedures surgeons at Lucile Packard Children’s Hospital Stanford have ever faced – so complicated that the operation keeps getting pushed back.

After originally planning to perform the surgery in January this year, the team decided on the first week of December.

Surgeons spent the last few months inserting tissue expanders, a common tactic in separation of conjoined twins.

It was a way of stretching the skin gradually so that, when it came to the reconstruction surgery, they have more to move and manipulate.

Aida was urged to abort the girls when she and Arturo surprisingly fell pregnant two years ago – when she was 44 and he 49. Without hesitating, the couple – who already have three kids in their 20s – went ahead with the pregnancy

Like all two-year-olds, twin sisters Eva and Erika Sandoval are excitable, playful, and beginning to develop mentally and physically. But that brings health challenges

Aida said last month that she was confident the surgery would be a success, and that it would allow Erika – the smaller and weaker of the two – to grow into her own person

While Arturo continues his construction work near their home in Antelope, California, Aida has been forced to move to Palo Alto to live close to the hospital with the girls

In a lengthy profile of the family, the Sacramento Bee last month described how the cost and scale of the operation – and pre-surgery – has taken such a heavy toll on the family. 

Aida was urged to abort the little girls when she and Arturo surprisingly fell pregnant two years ago – when she was 44 and he 49.

Without hesitating, the religious couple – who already have three kids in their 20s – went ahead with the pregnancy.

But life was becoming insurmountably difficult for the girls.

Aida has been forced to move to Palo Alto to live close to the hospital with the girls while Arturo continues his construction work near their home in Antelope, California, the Bee reported. 

Nonetheless, Aida told the paper she maintains her faith: ‘You just have to remember that doctors tell you the worst. 

‘I have faith in God, and I know that if it’s meant to be, it will be.

‘They want life, and they’re going to fight for it.’ 

It was one of the most complicated procedures surgeons at Lucile Packard Children’s Hospital Stanford have ever faced – so complicated that the operation kept getting pushed back

She said she was confident that the surgery would be a success, and that it would allow Erika – the smaller and weaker of the two – to grow into her own person.

The Bee calls Eva ‘the larger and more dominant twin’ and describes how she carries them both around.

‘She thrust forward with two arms and one thick leg, while her sister scrambled to support herself on spaghetti-thin limbs, sometimes giving up entirely and letting herself be dragged along,’ reporter Sammy Caiola writes. 

Aida told the paper: ‘In moments where one is tired or she’s sick, and the other wants to go play, I want her to be able to do that.

‘That’s something they’ll get when they’re separated – their individual limelight.’

• The couple is raising money to cover the cost of their living and medical expenses via YouCaring
• For more information about the Sandovals, visit their Facebook page Arturo’s Angels: Born as one, soon to be two