Pediatric surgeons ensure a future twice as nice

In November 2011, a team led by Virginia Commonwealth University pediatric surgeons successfully completed the separation of 19-month-old conjoined twins Maria and Teresa Tapia of the Dominican Republic, the first surgery of its kind at the Children’s Hospital of Richmond at VCU.

As doctors in the Dominican Republic recognized they wouldn’t be able to provide the quality of care necessary for the twins’ condition, they reached out to the World Pediatric Project, which, in turn, reached out to a team led by David Lanning, M.D., Ph.D., associate professor in the Department of Surgery and CHoR’s surgeon-in-chief, who had worked with the organization in the past.

Upon initial examination, Lanning and his team discovered that Maria and Teresa, joined at the lower chest and abdomen, shared parts of their biliary system, pancreas glands and the first part of their small intestine, as well as their liver, presenting a major challenge to the surgery.

But, what started as a medical case that would require the volunteer efforts of more than 45 physicians and pediatric specialists quickly turned into a community rally that extended far beyond the hospital walls.

Students in VCU’s Department of Fashion Design and Merchandising designed custom dresses for the twins to wear while they awaited surgery. Morgan Yacoe, a senior in the Department of Sculpture and Extended Media, spearheaded an effort to create a plaster casting mold of the twins’ bodies to assist surgeons’ preparation for the surgery and cosmetic care required after separation. And Audrey Kane, an occupational therapist at VCU and a certified car-seat technician, designed a special car seat large enough to comfortably accommodate both Maria and Teresa.

On Nov. 7, they put their plan in motion, embarking on a 20-hour series of procedures to divide the twins’ liver and other shared organs before reconstructing their abdominal walls. A month later, doctors released the girls to the Hospital Hospitality House and, following their initial rounds of occupational and physical therapy, Maria and Teresa returned home to the Dominican Republic in December.

The twins celebrated their second birthday in April, the same month Dominican Republic president Leonel Fernandez Reyna presented Lanning with the country’s highest civilian honor, the Order of Christopher Columbus rank of Knight, for his efforts to separate the girls.