e INDEPENDENT-LOCALLY OWNED WI%+ SUNDAY MORNING EDlTlON. \ \ Clara's intestine to connect to lower half of colon. th a kidney which drains r sister. Two of *the con- will be cut and reconnected to giveeach twin her own complete urinary tract. Siamese Twins Undergo Surgery Here By'DAVID M. CLEARY Of The Culletin Staff dlara and Altn .~Rodriguez, .&nont~>-old Sia- mese tsvins who came here from their native Dom- inican Republic ten days ago, are undergoing sep- aration surgery today. The aim is to make each girl an individual, independent of the sister to lvhom she has been joined since birth. Dr. C. Everett Koop, surgeon-in-chief at Chil- dren's Hospital of Philadelphia, made the first in- cision at 8 A.M. today, and his 23-member surgical team "hopes" to finish the highly complex opera- tion by about 4.30 this afternoon. Then will begin an agdnizing wait of three weeks or so, to see whether the girls will heal. Each will have .a large area of open wound where she was previously joined to her sister, and the for- :-.- r mation of skin `&v @osti wounds was said by Dr. Koop yesterday tb be "the biggest question I see." As the doctor spoke yesterday, Clara and Alta we& bright-eyed and smiling. Their anesthesia was begun gradually last night with sedative drugs, and more potent anesthetics were given this morning, two hours before surgery began. Without today's operation, neither of the pretty little girls could ever expect to sit or stand normal- ly, nor to talk. Their legs have been so intertwined since birth that they get in the way of each other. Unlike girls who underwent a similar but more complex and unsuccessful separation operation at St. Christopher's Hospital for ChiJdren here in 1966, the R,odriguez girls were in-no danger of death- if thir- dpgration were not performed. They steadily%mce -birth, and %ave no hdait prdbleini, But, unless Xxy're. +a: rat&J ez&P&S%,-Jegs wflt shrivel from-disusd; they:ca? develop into `I norm&l women only if each has an opporiuni- ty to learn to -walk, " and play at the usual stage `df childhood for thdse activities.. &d@s. complex, surgery, in- rwwrplg major operations kith in the abdomen and gelvis, will be successful. Pelvic bones of the twins kave . been fused together &nce%irth, anti when sepa- tated each girl will have an incdmplete pelvis, shaped like % "C rather than a complete ring. No Charges The twins, ,lheir mother fa- rita, and an aunt were flown here by a suburban Phila- delphia family that learned of the girls' plight through a relative in Puerto Rico. Nei- ther Children's Hospital nor any of The doctors is charging for their services. Separation of "conjoined" twins (a term doctors prefer to "Siamese") is difficult when both babies `share cer- tain organs, as the Rodriguez girls do, The operation must be done in clea$ly def%ti phases. each depqndent upon success of previo4 ones., L If the girls were newborn, it would be possible to bend their pliable pelvic bones into a ring again, said Dr. K~op, but at their present state of growth it wiil probably be recessary to fracture each pelvis in two places, form rings that are wired togetheY, and await hone fusion. Inside the ;Ibdomco aEd -pelvis shared b:- fbe two girls : re other m,i;or ItldlfOrX i- tlons, in that: Ever since theii; birth, the Rodrigllez twins L reported last weekend to: be nine- months-old, becauie of a mis- taken translation from Span- ish - have been joined facing each other by a bridge of tis- sue, seven inches wide, where it begins. at the lower ends of their breastbones, and widen- ing as it continues downward. - Each g!r! has her owr ,,stomach and abol;t 90 percent ,.of her small intestine. Ther the two intestines join for the fina! 12 inches or so. goinl; into a corn or, large intestlnr t colon) 8 rectum. ' - heir livers are a:% $ r i d g e d to;;ether, mostI> :;terved by separate blood VPS- p&Is, bul one largt, ar:pry car. ,rles blood to bntb - Each giri has ;, b~dn~,:. connected ib! ,f i;rcte:, lo 1'72 yladder of her iis!er Several Teams Below their waists, the girls have essentially a single hip structcre. Removal of the tis- sue bridge will ileave each girl w'th an abdomen having virtually no skin. open to in- fection unless heroic mea- sures are taken to shield them from germs until skin forms. FoLowing a: flaborate op- eratlon plan c!rawr: :fp cs.cT the pas! sever;11 days. se~rra: surgica! te;i ms arc ht-inc formed - and relormcd - at various :. sta'lf s Of to&l-:`s procedure. They will be put in sepa- rate, sterile rooms after sur- gery. Since the very act of breathing can interfere with. skin formation, it rnify also be ,, neceszary to immoblllze their chest and abdomen muscles. L Then an oxygen and air mix- ture can be supplied directly into their lungs, Dr. I