U.S. surgeons began a surgery Wednesday that could allow Filipino twins joined at the tops of their heads to look into each other's faces for the first time, a New York hospital said. Dr. David Staffenberg, co-leader of the surgical team and chief of paediatric plastic surgery at the Children's Hospital At Montefiore in the Bronx, reported that the first incision for the 27-month-old boys Carl and Clarence Aguirre began at 10 a.m. (1400 GMT). Doctors expected the surgery would last into the evening. It is the fourth and possibly final surgery in a series of operation to separate the boys, and its main purpose is to separate one major vein in the boys' heads and several minor ones, surgeons said. "The upcoming surgery will be the most complex for the twins," said James Goodrich, the other leader of the surgical team and chief of paediatric neurosurgery. "While we are confident that Carl and Clarence are ready for the final stage, we are also prepared to hold back if it should become apparent during the surgery that they are not able to tolerate a complete separation at this time." The boys' mother, Arlene Aguirre, brought them to New York from the Philippines in September for the surgeries, which have already partially separated the boys' brains and inserted tissue expanders under the skin above the Carl's and Clarence's left ears to increase the volume of skin to cover their skulls once they are separated. Surgeons had also used a series of separation procedures to build up Carl's weak system of veins while Clarence already had a fully developed venous system. Most twins joined at the head have been separated in one major surgery that often lasts days. --SP 2039 Local Time 1739 GMT
