First-of-Its-Kind Surgery Successfully Separates Conjoined Twins in Michigan
Two teams of surgeons, one for Amelia and one for Sarabeth, and over a dozen medical staff spent several months how to separate the conjoined twins safely and give them a chance to live ‘literally’ separate lives.
When they were born in June last year, Sarabeth and Amelia Irwin were reportedly locked in an embrace. Conjoined from their chests down to their bellies, Dr. Marcie Treadwell said, these identical twins' arms wrapped around one another as they were cautiously lifted from their mom's womb at Michigan Medicine's Von Voigtlander Women's Hospital in Ann Arbor.
Nearly 14 months after birth, On August 5, the twins went back to Ann Harbor, where they had gone through an 11-hour surgery at CS Mot Children's Hospital, becoming the first known set of conjoined twins undergo a successful separation in Michigan.
Dr. Treadwell, who is the Michigan Medicine's Fetal Diagnosis and Treatment Center's director said,
"They're so rare," adding, only 1 in every 100,000 "to 1 in every 250,000 pregnancies engage conjoined twins."
The doctor also said that only a few survive delivery. Even fewer in a similar condition live long enough to be released from the hospital and return home like what happened to the Irwin twins.
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A Surgery, First of its Kind
According to reports, two teams of surgeons, one for Amelia and one for Sarabeth, and over a dozen medical staff spent several months how to separate the conjoined twins safely and give them a chance to live 'literally' separate lives.
Just a couple of weeks from the so-called "first-of-its-kind surgery," Detroit Free Press reported, Sarabeth reportedly sucked on a pacifier as she leaned against her father's leg. Meanwhile, the news site also said, Amelia, who spotted a mobile phone on the ground, started crawling to reach it.
The twins' father, Phil Irwin, shared, "Other than taking our word for it," one would almost never know the twins were conjoined. Their mom Alyson, on the other hand, said the two "are doing great.
Neither of the parents, though, could have dreamed they could say that about their two girls when they first found out they were having conjoined twins in late February last year.
A Disturbing Ultrasound
33-year-old Alyson said there was something different about the pregnancy, but they could not pinpoint what it was.
The 33-year-old mom who sells feed and fertilizer to farmers added, she thought they were having a baby boy then, but it felt different compared to her previous pregnancy when she carried their now-three-year-old girl, Kennedy
The couple looked forward to their "20-week prenatal check-up" set in late February 2019. They were excited to see their baby's images from the ultrasound.
Phil recalled that the ultrasound technician moved the wand around on his wife's belly and then swiftly excused herself to call the doctor.
It took five minutes, the twins' father said, before the doctor entered the room, and that was then they found out they were having conjoined twins.
Alyson admitted, it felt like they received the worst news, especially that the statistics were not good. The couple said the doctors told them they had never seen anything similar to that case before, and thus "their hearts were breaking for us, but there wasn't anything they could do."
That was when the Irvings were referred to a high-risk obstetrician, and in 24 hours, the Irvings got to Ann Arbor, meeting at Michigan Medicine with Treadwell.
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The Separation Plan
Both girls were vigorous when they came out, said Treadwell. However, even though the outlook was remarkably good given the odds, premature birth, not to mention being conjoined twins, Amelia and Sarabeth stayed at the hospital for 85 days.
Mott pediatric plastic surgeon, Dr. Steven Kasten started working with the Irwins soon after the twins' birth, to plan how they would develop enough skin to cover both girls' abdomens once they got separated.
The twins underwent a preliminary surgery "to add tissue expanders" on both sides of their bodies. Kasten explained this was "basically a silicone balloon," and they put one on each of the twins' side, right along the part where they were joined.
A Successful Surgery
According to one of their surgeons, these twins shared a chest wall, although each girl "Had their own diaphragm muscles."
The twins had one tiny, shared sternum bone, needed to be split, and "separate livers that were fused," the surgeon explained.
Furthermore, even though the girls had individual hearts, they shared a typical outer membrane or shielding sack known as the pericardium.
There was one thing they really didn't know, and the surgeons said until they were separated and the breathing tube came out.
It was what the girls' chest wall mechanics would be like. The doctors said Breathing is a complicated thing that engages the lungs, the diaphragm muscles, and the chest wall, and it needs, to all kinds of work, in sync.
According to Mott pediatric and fetal surgeon Dr. George Mychaliska, they really did not know how well the twins' chest wall would function, although "it worked actually beautifully."
Dr. Mychaliska, who said he first met the Irwins in March last year, added, their team used "an innovative intravenous fluorescent dye" as their guide when they had the twins' livers separated.
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Sep 21, 2020 07:40 AM EDT
