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New York City, NY (November 25, 2003)  --  Doctors at The Children's Hospital at Montefiore (CHAM) say that Carl and Clarence Aguirre, 19-month-old conjoined twins from the Philippines, are "doing very well with no special issues" today, one day after the second in a series of operations that eventually will separate the boys, who were born joined at the tops of their heads.

"Carl, the larger of the boys, was moving around much more than his slightly smaller brother, Clarence," said James T. Goodrich, MD, director of Pediatric Neurosurgery, CHAM.  "We want the boys to be at the same level, so some sedation is being given to Carl to keep him a bit less active."

"Neurologically, the boys have done spectacularly," Dr. Goodrich said. "We've now taken a neurological assessment and, at this time, there is no sign of brain or nerve damage."

Carl and Clarence had some of their major shared blood vessels divided and tied off during yesterday's five and one-half hour surgery, in which surgeons also pushed apart the boys' brains, which were touching but not intertwined.

"We are focusing now on the continuing strong recovery of the boys from the surgery," said Dr. Goodrich.  "They need to stay healthy and gain strength for the upcoming procedures."

David Staffenberg, MD, chief, Pediatric Plastic Surgery, CHAM, yesterday inserted a tissue expander beneath Carl's scalp which will be slowly filled with saline to encourage the skin to stretch and grow in preparation for the final separation surgery. 

"One of our main goals now is to stretch the skin on the boys' skulls so there will be enough to completely cover their scalps when the final separation procedure takes place," said Dr. Staffenberg.

"Clarence and Carl are actively moving around in their crib today, and already making their wishes known as loudly as usual," said Dr. Staffenberg.  "Arlene spent the day with her boys, and it is nice to see the happiness and relief on her face."

"For the next few days, Carl and Clarence will be closely cared for by our pediatric intensive care experts," said Dr. Staffenberg.  "Every day I admire and appreciate the skill of our nurses, anesthesiologists, pediatricians and  neurosurgeons here at CHAM.  It's a team of remarkable people who care deeply about Carl, Clarence and all our patients."