Conjoined twins successfully separated
Published 11:01 am Friday, April 26, 2013
RICHMOND—Conjoined twin girls from Franklin were surgically separated Monday at Children’s Hospital of Richmond at VCU.
The 14-hour operation completed a series of procedures begun last year, including the division of their liver. A’zhari and A’zhiah Jones, twin girls of Nachell Jones and Carlos Lawrence, are in stable condition in the Neonatal Intensive Care Unit following the surgery, where they have been since being born on Oct. 10.
Nachell’s brother Chris Evans of Raleigh, N.C., said via telephone yesterday his nieces were “progressing.” Of his sister he said, “She’s doing well – she’s elated now that they are successfully separated. We are all overjoyed.”
“Everyone was overcome with emotion – it was just a joyous day, once we received the official word,” Evans said.
Grandparents Waverly and Carolyn Lawrence said yesterday the twins were in critical but stable condition but also “are doing fine.” The grandparents said there was no definite date yet for when the girls would come home.
“They are going to have to go through therapy,” Waverly said.
Carolyn Lawrence explained the twins were being fed through tubes and would have to learn how to bottle feed. The grandparents said they were extremely thankful for all of the prayers and support they’ve received and asked the community to continue praying for the twins.
“We’re very optimistic that the twins will have a full and complete recovery,” said Dr. David Lanning, surgeon-in-chief at the Children’s Hospital. “At this point we don’t anticipate any future operations or need for any long-term medications. I see the girls living full happy lives as individuals.”
The complex, multidisciplinary procedure began 6:45 a.m. Monday, and was the second separation of conjoined twins at the hospital in the past 18 months.
The Jones twins, classified as thoracopagus, were joined at the chest and abdomen and shared a liver and the pericardium, the double-walled sac containing the heart and the roots of the great vessels.
Led by Lanning, the care team included nearly 40 physicians, surgeons, pediatric subspecialists, nurses, surgical technicians, occupational and physical therapists and ancillary staff members.
Nachell Jones was surprised at 12 weeks gestation to learn that she was having twins, and she said she was shocked at 13 weeks when she discovered through advanced sonography that her twins were conjoined. Jones was admitted to VCU Medical Center at 35 weeks for observation. At 36 weeks, Jones gave birth through a planned cesarean section to 10-pound (combined weight), 17-inch conjoined twins.
Five days after birth, CT scans were taken of the twins’ chests, abdomens and pelvises and revealed a conjoined liver and a shared pericardium.
The first stage of the phased separation began Oct. 25 when surgeons separated the conjoined liver and closed the girls’ abdomens.
On Feb. 14, surgeons placed tissue expanders in the abdomens. The balloon-like expanders enabled the growth of excess skin to be used for closure and reconstruction following surgery.
“We made the decision to proceed with the final separation once the girls gained weight and their renal and heart problems resolved,” said Lanning.
Seven anesthesiologists monitored the girls’ vital signs and managed pain control during the surgery. Following separation, A’zhari was moved to another operating room and surgeons began the final reconstruction of the girls’ abdomens. Following reconstruction, the twins were transported to separate rooms in the Neonatal Intensive Care Unit, where they will recover with the help of the same nurses who have cared for and watched them grow over the past six months. The girls eventually will be reunited in one room.
“The nurses are very caring and like my family,” Nachell said. “They are very supportive of me and the girls. It’s like they are their own kids.”
“It has been one hard journey, like a rollercoaster,” she said. “Some days it’s great and other days it’s hard. Today is one of the great days. They are my little miracles.”
The twins’ uncle Chris Evans said that if anyone wants to help in the form of a donation or contribution, that they can do so at any BB&T Branch and specify it is for The Jones Twins.
Editor’s Note: Information for this article was provided by Children’s Hospital of Richmond at VCU Office of Public Affairs.