Lisandra Sanatis looks at her twin daughter, Teresa Tapia, as daughter Maria Tapia looks on Children?s Hospital of Richmond at Virginia Commonwealth University in Richmond, Va., Thursday Dec. 1, 2011. The conjoined twins were separated during an operation at the hospital Nov. 8, 2011. The twins are expected to be released from the hospital Friday and are expected to go back home to the Dominican Republic before Christmas. (AP Photo/Steve Helber)
Lisandra Sanatis looks at her twin daughter, Teresa Tapia, as daughter Maria Tapia looks on Children?s Hospital of Richmond at Virginia Commonwealth University in Richmond, Va., Thursday Dec. 1, 2011. The conjoined twins were separated during an operation at the hospital Nov. 8, 2011. The twins are expected to be released from the hospital Friday and are expected to go back home to the Dominican Republic before Christmas. (AP Photo/Steve Helber)
Maria Tapia, and TeresaTapia play in a playroom at Children?s Hospital of Richmond at Virginia Commonwealth University in Richmond, Va., Thursday Dec. 1, 2011. The conjoined twins were separated during an operation at the hospital Nov. 8, 2011. The twins are expected to be released from the hospital Friday and are expected to go back home to the Dominican Republic before Christmas. (AP Photo/Steve Helber)
Lisandra Sanatis holds her daughter, Teresa Tapia, in their room at Children?s Hospital of Richmond at Virginia Commonwealth University in Richmond, Va., Thursday Dec. 1, 2011. Sanatis' conjoined twin daughters were separated during an operation at the hospital Nov. 8, 2011. The twins are expected to be released from the hospital Friday and are expected to go back home to the Dominican Republic before Christmas. (AP Photo/Steve Helber)
Maria Tapia, and TeresaTapia play in a playroom at Children?s Hospital of Richmond at Virginia Commonwealth University in Richmond, Va., Thursday Dec. 1, 2011. The conjoined twins were separated during an operation at the hospital Nov. 8, 2011. The twins are expected to be released from the hospital Friday and are expected to go back home to the Dominican Republic before Christmas. (AP Photo/Steve Helber)
Maria Tapia, and TeresaTapia play in a playroom at Children?s Hospital of Richmond at Virginia Commonwealth University in Richmond, Va., Thursday Dec. 1, 2011. The conjoined twins were separated during an operation at the hospital Nov. 8, 2011. The twins are expected to be released from the hospital Friday and are expected to go back home to the Dominican Republic before Christmas. (AP Photo/Steve Helber)
RICHMOND, Virginia (AP) ? Two formerly conjoined toddlers from the Dominican Republic have left a Richmond hospital after recovering from separation surgery, and doctors predict they'll be ready to go home by Christmas.
Maria and Teresa Tapia left Children's Hospital of Richmond at Virginia Commonwealth University on Friday. At a news conference before their departure, the girls clapped and waved and one kissed the lead doctor on their surgical team, Dr. David Lanning.
"I thank God and everyone who made this possible," the girls' mother, Lisandra Sanatis, said through a translator.
The 20-month-old twins were attached at the lower chest and underwent complicated, nearly daylong surgery on Nov. 7. In a series of procedures, the surgical team divided the twins' liver, pancreas and other shared organ systems and reconstructed their abdominal walls.
While they're getting accustomed to exploring their surroundings separately, they still stay near each other and hold hands when they walk.
Lanning said Friday that both children have been recovering well, and doctors don't expect them to require any long-term medical treatment, except possible minor surgery to construct belly buttons.
"Overall, I don't think we could have asked for a better outcome," he said at Friday's news conference.
They'll lead healthy, long lives, with the ability to "be together but make independent decisions."
Maria, the smaller of the two, weighs about 19 pounds, and Teresa weighs about 26 pounds. Lanning expects the disparity in their weight, caused by the configuration of their small intestines and blood flow from the liver, to gradually even out.
Maria's pancreas is slow to produce digestive enzymes, but she is taking replacement enzymes, and doctors are monitoring her colon function. Teresa is undergoing treatment on the incision where the girls were separated, Lanning said.
Doctors, nurses, volunteers and others who cared for them gave the girls and their mother and aunt a warm send-off from the hospital Friday afternoon. Lanning pushed a new double stroller to the van that took the family to a nearby residence for patients and their families.
The girls will stay in Richmond for follow-up medical visits and outpatient therapy to continue working on walking and other motor skills now that they're no longer attached. Lanning said they're on track to return to their native country by Christmas.
After being in Richmond for several months now, Sanatis said she and her daughters have grown fond of everyone they've met. But they're more than ready to go home and reunite with the twins' father and three other siblings.
The twins have become celebrities in the Dominican Republic, with supporters including the country's first lady, Margarita Cedeno de Fernandez, who visited Richmond on the day of the surgery.
The World Pediatric Project, a nonprofit surgical-care provider for children in Central America and the Caribbean, sponsored the toddlers' medical care, along with the family's stay in the United States. Lanning has been a surgical volunteer with the group for several years.
About a half-dozen separation surgeries are done in the U.S. annually, and maybe double that number worldwide.
Conjoined twins account for between 1 in 50,000 and 1 in 100,000 live births worldwide. The condition is three times more likely to occur among females than males. A third of conjoined twins are attached at the lower chest, as in the case of the Tapia twins.
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Online:
Children's Hospital of Richmond at VCU: http://www.childrenshosp-richmond.org/CMS/index.php
World Pediatric Project: http://www.worldpediatricproject.org/
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Zinie Chen Sampson can be reached on Twitter at http://www.twitter.com/zinie
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