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Separation Surgery

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Surgery to separate conjoined twins, Regina and Renata Fierros, began at 6:21 a.m. on Wednesday, June 14th.  Regina was transferred to Childrens Hospital's Pediatric Intensive Care Unit at 2:47 a.m. on Thursday, June 15th for post-operative care.  Her sister, Renata, joined her at 3:58 a.m. 

The separation involved a dozen surgical procedures, according to Dr. Stein, the pediatric surgeon who headed the surgical team. "The first phase included dividing the breastbone, liver, intestine, urinary bladders, genital organs and the bony pelvis. During the second phase, the chests, intestines, vaginas, ureters, pelvises and body walls all were reconstructed." 

While one of the rarest types of conjoined twins, Ischiopagus twins also are among the most complex to separate, according to Dr. Stein. "Since they involve so many organ systems " liver, intestine, urinary, reproductive, vascular and musculoskeletal systems, we are utilizing nearly every area of expertise offered at Children's Hospital Los Angeles."

 

After Separation Surgery

After their successful separation surgery, Regina and Renata were cared for in the 20-bed Pediatric Intensive Care Unit (PICU) at the hospital.

The care of the children and their family were under the direction of Niurka Rivero, M.D., and another large team of nurses, respiratory therapists and physicians in the "…crucial…" 24-48 hours following surgery, according to Randall C. Wetzel, MB, BC, FCCM, FAAP, chief of the Department of Anesthesiology Critical Care Medicine at the hospital.

Children in the PICU are treated by pediatric intensivists, some of whom are double and triple board-certified with expertise in cardiology, pulmonology and anesthesiology in addition to training in general pediatrics and critical care medicine.  

 

The Surgical Team

Listed below are the fifteen members of the surgical team that separated conjoined twins, Regina and Renata Fierros.

James E. Stein, M.D., FACS, FAAP 

Dr. Stein headed the surgical team.  He was joined by Drs.:

Dominic Femino, M.D.

Dr. Femino led the orthopaedic team.  He was joined by Drs.: 

John Gross, M.D., FACS 

Dr. Gross led the plastic surgery team.  He was joined by Drs.:

William McIlvaine, M.D., C.M., FRCPC, FAAP

Dr. McIlvaine led the anesthesia team.  He was joined by Drs.: