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Update on Condition of Separated Twins

Aired August 6, 2002 - 19:39   ET


ANDERSON COOPER, CNN ANCHOR: Thanks very much, Paul. We are going to take you now to UCLA Medical Center to hear from doctors who have been operating on the Guatemalan twin girls conjoined at the head and separated. Almost a full day of surgery. One of the two girls had five more hours of surgery today to stem bleeding on her brain. We're going to be listening now to doctors now at the medical center.


UNIDENTIFIED FEMALE: introduce the lead surgeons who will are then going to introduce their team members. So I appreciate your coming, and I also wanted to let you know, this will be the last update from the hospital today, unless there is a significant change.

So I know you guys are calling all the time. But just try not to call us again. Thank you.

DR. MICHAEL KARPF, DIR., UCLA MEDICAL CENTER: Good afternoon. I think you see behind me that this is really a team effort at UCLA. You have some extraordinary talent here. I'm going to introduce the lead surgeons. I'm going to have them introduce the members of their team. And these are the people who can answer your questions in more detail.

You have all heard about Dr. Jorge Lazeraff, who is standing right here. He will introduce the neurosurgery people, Dr. Henry Kawamoto from plastic surgery. Come on up here, Henry. And this is an extraordinary effort by anesthesia, and that was led by Dr. Barbara Vanderweil (ph). So I'm going to let these folks take over from here. And as I said, this was clearly a team effort. These folks ought to be congratulated on how far we've gotten, and they'll introduce their people and answer questions.

DR. JORGE LAZERAFF, NEUROSURGEON: I want to emphasize, including that the team effort that Dr. Karpf was also part of our team since Day 1, and the whole UCLA Medical Center was part of our team. We don't have here the nurses that took care of the children. We don't have here the nurses who work in the OR, and we don't have here the team who is taking care of those children now in the pediatric intensive care unit.

But specifically yesterday, we worked on the neurosurgical part with Dr. John Frissey (ph), (UNINTELLIGIBLE), and Dr. Yitzhak Freet (ph), and the three of us, together with Triman Eritu (ph), our chief resident, we were able to do what anesthesia and plastic surgery allowed us to do -- Barbara.

BARBARA VANDERWEIL, ANESTHESIOLOGIST: I just want to say that a lot of advanced planning and teamwork on the part of the anesthesia team got us through the challenges of the last 24 hours, and I want to thank my team. I want to introduce Dr. Patel (ph), Dr. Wohl (ph), Dr. Iad, and Dr. Sharon Ignarro (ph), who were with us in the last 24 hours in the operating room, and who get an enormous amount of credit or deserve an enormous amount of credit for all of the effort that went into this procedure.

And on behalf of the anesthesia team, I also want to say that it was really an honor to take care of these lovely little girls, and with that I will turn over the microphone to Dr. Kawamoto.

UNIDENTIFIED REPORTER: Could you speak up?

UNIDENTIFIED REPORTER: Could you spell your names before you talk, please?

HENRY KAWAMOTO, PLASTIC SURGEON: Kawamoto. K-A-W-A-M-O-T-O, And I headed the plastic surgery team, which consisted of the chief resident Andrew Smith (ph), craniofacial fellow, Mark Eurada (ph), and we're missing one. Chris Chrissera (ph), kind of late last night, you know.

We had a great team effort. Now the message to be sent to the UCLA athletic team, that if they had such a great team effort they'd be No. 1 in the nation every year. And I cannot stress what a great experience we had of working with one another.

UNIDENTIFIED REPORTER: How are the girls doing?

LAZERAFF: They're doing -- I mean, considering what they went through and considering the type of procedure that they had -- they're doing extremely well. One of them had to be taken back to the OR this morning because she had developed a collection of blood between the skin and the brain that was pushing on to her brain. And we took care of that. And she's back to the intensive care unit and she's stable, as well as Maria de Jesus -- she's also doing very well.

UNIDENTIFIED FEMALE: We know that they're working moment to moment, day by day. At what point, what signs will tell you that the twins are out of the danger zone?

LAZERAFF: As I always said, in the prior occasions when they will smile back to us, then we will know that they are back to where they were before the surgery.

UNIDENTIFIED REPORTER: Dr. Kawamoto, you headed up reconstructive surgery. How much will we be able to tell physically when these little girls grow up that they've even had this surgery?

KAWAMOTO: Well, because we didn't have enough scalp and we had to do some expanding and use skin grafts, right now their hairdo isn't much better than some of the undergraduate students at UCLA. In the future, we will be able to shift or stretch the skin that we transplanted to give them a more normal appearance to their scalp, and also bone graft the areas of deficiency. But you have to understand the goal this time was to get them separated and get it done safely.

COOPER: We are going to continue coverage of this press conference now regarding the twin girls who were separated earlier today. We're also going to bring in Dr. Sanjay Gupta, CNN medical correspondent, also a neurosurgeon right now, just to discuss what he is hearing and get his perspective. Dr. Gupta, as you listen to these doctors, what goes through your mind?

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Well, I'll tell you, they're still very optimistic about things, no question. They certainly were optimistic before the start of the operation, and after the first operation, where the separation procedure occurred, no doubt I think people -- everyone was concerned when Maria Teresa, the larger of the two twins, actually, had to be taken back to the operating room.

What we've heard, a little more detail, is that the blood collection was actually some of it on top of the brain, some of it actually within the brain. That's of no doubt concern, Anderson. That's not an entirely unexpected thing after the operation of this size, but of concern.

ANDERSON: That would be a subdural hematoma?

GUPTA: That's right. And Dr. Lazeraff, who we just heard from, the neurosurgeon there, still very optimistic. No both girls are listed in critical condition still, but stable and I think that that's no doubt a very good sign overall for both girls.

COOPER: The doctors certainly seem in a good mood. I mean, they've obviously had about a full day of surgery. I think the first surgery was some 22 hours, the second surgery about five hours. As one of the people asked the doctors, when do we know these little girls are out of danger?

GUPTA: Right. And the doctor replied, when they smile back at me. But I think that the answer can be a little bit more specific. Having been under anesthesia for that long, the girls, you could see in those pictures, the girls still have the breathing tubes in and things like that. They're probably going to keep these two little girls on the ventilators to breathe for them for some time so they can control pain and pain management adequately during that time.

So it will probably be some time before you can really wake these girls up, really see if they are moving well, seeing if they're talking like they used to be talking before the operation, and see if they're just the same as before. That could be some time, Anderson. This is certainly not measured in hours, maybe not even days. Perhaps weeks before you know for sure, are these girls, do they have any subtle signs, any changes associated with stroke, any changes associated with mild brain damage.

But sounds like you heard the same thing I did, which is that the surgeons are very optimistic. COOPER: Well, as one of the surgeon said, the girls are doing extremely well. Dr. Gupta, thanks for joining us.

We're going to have a lot more -- CNN is obviously going to be continuing this story as it develops all night long. Connie Chung coming up at 8:00 p.m. will have a lot on the latest developments. We're going to go back to "CROSSFIRE" right after this break.




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