By Kimberly Vetter
On February 17, 2015, a team of more than 40 clinicians from at least seven specialties spent 26 hours performing an operation that would separate conjoined twins, Knatalye and Adeline Mata. Here are the pediatric subspecialty teams that executed the historic separation surgery.
Led by Helena Hippard-Karlberg, MD, a team of five anesthesiologists prepared the Mata twins for surgery by inducing and intubating them, establishing IV access, placing arterial lines in both girls and anesthetizing them. During the lengthy procedure, at least one member of the anesthesiology team was in the operating room at all times, monitoring the twins’ vital signs, including their blood pressure, heart rhythm, temperature, level of consciousness and amount of oxygen in the blood. The anesthesiology team also worked with the after-care team to keep the twins comfortable post-surgery.
CONGENITAL HEART SURGERY
Dean McKenzie, MD, represented Congenital Heart Surgery during the procedure, separating the girls’ pericardial sac, which lines the heart. Each twin was born with her own heart, but they shared a pericardial sac. McKenzie separated that sac, giving each twin one of her own. He also repaired Adeline’s heart defect, patent ductus arteriosus, and helped close the girls’ chests.
OPERATING ROOM STAFF
A team of nine registered nurses and two certified surgical technologists maintained a sterile field throughout the more-than-26-hour procedure and assisted surgeons with their instruments.
Orthopedic surgeons William Phillips, MD, and Scott Rosenfeld, MD, helped separate and reconstruct the girls’ pelvic bones, giving them the chance to walk.
Darrell Cass, MD, and Oluyinka Olutoye, MD, orchestrated the entire procedure and were present from beginning to end, taking part in all aspects of the operation. After the actual separation, Cass continued to operate on Knatalye, and Olutoye focused on Adeline.
PEDIATRIC UROLOGY AND PEDIATRIC GYNECOLOGY
Three urologists and two pediatric gynecologists were in the operating room, working together on the girls’ pelvic region. Although each girl had her own pelvic organs — bladder, uterus and ovaries — each of those organs received blood supply from the other girl. Chief of Pediatric Gynecology Jennifer Dietrich, MD, and urologist Chester Koh, MD, led the team that helped preserve all of the girls’ pelvic organs.
Three plastic surgeons, including Texas Children’s Chief of Plastic Surgery Larry Hollier, MD, and plastic surgeons Edward Buchanan, MD, and David Khechoyan, MD, made the initial incisions into the twins and sewed the girls’ final stitches. During the first few minutes of the procedure, the team took two custom-made tissue expanders out of the girls’ abdomens. The expanders, placed months earlier, stretched the girls’ skin, allowing the surgeons to close them more easily at the end of the procedure.
John Goss, MD, helped separate the girls’ livers, which were fused together.
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