Health & Medicine

‘They look amazing.’ Conjoined twins Erika and Eva survive separation surgery

Conjoined twins Erika and Eva survive separation surgery

Conjoined twins Erika and Eva Sandoval stable following successful separation ​at Lucile Packard Children's Hospital on Tuesday, December 6 in a 17-hour surgery.
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Conjoined twins Erika and Eva Sandoval stable following successful separation ​at Lucile Packard Children's Hospital on Tuesday, December 6 in a 17-hour surgery.

On Wednesday morning, the long-sought dream of having two separate little girls became a reality for Aida and Arturo Sandoval. Exhausted but happy, the Antelope couple exited the Lucile Packard Children’s Hospital Stanford for the first time in 30 hours, leaving their two now-separated daughters under sedation in the pediatric intensive care unit.

Two-year-olds Erika and Eva, who were born conjoined from the chest down, were successfully separated by surgeons after more than 17 hours of separation and reconstructive surgeries. The couple first saw their girls around midnight Wednesday.

“They look amazing. They’re amazing. They have their hair done, and they’re resting,” said Aida, outside the hospital’s pediatric intensive care unit. “We’re just going to take it one day at a time and let them catch up on their rest.”

After two years of carrying and caring for Eva and Erika as two girls fused together from the sternum down, Aida said it’s a little surreal seeing her daughters in two different beds. “It’s kind of like – ‘Where’s your other half?’ It’s going to take a little getting used to.”

Calling the surgery “a major success,” Art said he’s curious to see his daughters’ reactions when they wake up. “What are they going to do? How are they going to react?”

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Starting Tuesday morning, Eva spent 17 hours in the operating room, while Erika spent 18 hours, hospital officials announced Wednesday. The girls are now being monitored in the hospital’s pediatric intensive care unit, where they are recovering in adjacent beds. They’re expected to remain in intensive care for up to two weeks.

Lead surgeon Dr. Gary Hartman directed a team of about 50 physicians, nurses and operating room staff during the complex procedure that started at 8 a.m. Tuesday.

“The twins did very well,” Hartman said on Wednesday morning. “I’m very pleased; this is as good as we could have asked for.”

Going into surgery, they shared a bladder, liver and a third leg. On Wednesday, the parents confirmed that each girl has portions of the bladder, liver and small intestines. Each still has one leg.

On Tuesday evening, when word came that the first part of the surgery — the risky separation — had been successfully completed, daughter Esmeralda, 25, celebrated the news along with 40 other relatives gathered in the hospital’s auditorium.

“They’ve always been two little people emotionally,” she said. “It’s the physical part that’s difficult to grasp.”

As few as one of every 200,000 births results in conjoined twins, making the condition 200 times rarer than Down syndrome. About 50 percent of conjoined twins arrive stillborn, and 35 percent survive only one day, according to the University of Maryland Medical Center.

The girls, born in August 2014, spent their first seven months at the hospital before coming home to Antelope. They grew up into talkative, vivacious girls who danced, jumped and crawled while maneuvering their sprawling, seven-limbed body.

The twins also contracted more than two dozen urinary tract infections, a side effect of their shared bladder that required frequent hospitalizations. Eva grew physically larger than Erika and often dragged the smaller girl around as they played. Doctors worried that the growth disparity would become dangerous as the girls aged and advised the family to opt for separation.

Only a few hundred surgeries have ever been performed successfully to separate conjoined twins, and the Stanford doctors had calculated a 30 percent chance that one or both twins wouldn’t make it through Tuesday’s operation.

In October, Aida and the twins moved into a Palo Alto apartment to live closer to the medical staff at Lucile Packard, while Arturo stayed in the Sacramento area where he’s employed as a heavy equipment mechanic. The family started a page on the crowdfunding site YouCaring to raise money for rent and medical expenses, in addition to hosting other fundraisers.

After months of waiting, the surgery date finally arrived before dawn Tuesday when Arturo carried the girls out of their apartment and traveled with the entire family to the hospital.

Arturo, Aida and their older children said a tear-filled prayer around the girls before they were wheeled into the operating room. The first incision was made in their pelvic area around 1 p.m., the family said. By the afternoon, the surgeons had moved onto the girls’ shared liver and other organs.

The breakthrough came just after 4:30 p.m., when the couple learned that the twins had survived separation. By 6 p.m. the girls were being wheeled to separate operation rooms for hours of reconstruction.

Aida, too overcome with emotion to speak, gave the floor to Arturo, who updated the crowd in Spanish with help from his sister.

“They are officially split,” Arturo said.

English-speaking loved ones only fully understood when Arturo held up two fingers and moved them apart.

The uncles, cousins and grandparents erupted into their own symphony of cheers and sobs.

Jennifer and Tim Gorsuch, longtime friends of the couple, were part of a massive network of friends and family who helped move the Sandovals to Palo Alto and, closer to the operation date, prepare food for the extended clan.

“I was just completely overwhelmed with emotion,” said Jennifer Gorsuch Tuesday afternoon. “The last couple of days we just tried to control our thoughts and tried to only think positive. Now, hearing that it’s actually going well, is like finally being able to breathe.”

​An Antelope family handles life with conjoined twins Erika and Eva Sandoval who are joined at the pelvis, sharing a liver and other organs. The 1-year-old baby girls likely will undergo separation surgery next year. Conjoined twins occur in about

The Sandovals have upended their lives as they prepare for upcoming surgery to separate 2-year-olds Eva and Erika, siblings who are fused from the chest down. Doctors say the conjoined twins face a 30 percent chance of one or both not surviving.

Sammy Caiola: 916-321-1636, @SammyCaiola

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