Cook Children’s surgeons separate conjoined twins for first time in hospital history

Surgeons at Cook Children’s Medical Center in Fort Worth successfully separated conjoined twins for the first time in the hospital’s history, physicians announced Wednesday.

The girls, JamieLynn and AmieLynn, were born to Fort Worth parents Amanda Arciniega and James Finley in October, and were successfully separated in a surgery on Monday.

“They were joined from the lower part of their breast bone to their belly button,” said Dr. José Iglesias, the lead surgeon who operated on the infants.

The babies were connected at their side, and spent the first 16 weeks of their lives face-to-face, Iglesias said.

The sisters shared a liver, that was essentially a “double liver,” Iglesias said. The girls’ heart sacs and lung sacs were also touching and had to be separated, but their hearts and lungs were separate. The girls also shared a diaphragm that had to be divided.

The intricate surgery required more than double the number of surgeons, nurses and support staff as a typical surgery would to allow for a team for each baby. About 25 health care workers in the operating room donned different colored surgical caps — green for Amie and purple for Jamie — to indicate their twin.

The surgery took about 11 hours, including hours of preparation, dividing the liver and other tissues, closing the skin, and caring for each once they had been separated.

“Division of the liver is something we do frequently for things like tumors and cancers,” Iglesias said.

The team of surgeons announced the details at a press conference on Wednesday, and showed a video detailing the months of preparation. The video showed the fateful moment when Valerie Gibbs, the director of perioperative services at Cook Children’s, told Finley and Arciniega that their daughters were separated and sleeping safely on their own backs.

Finley and Arciniega were able to visit their daughters shortly after the surgery.

“Mommy’s here,” Arciniega told her daughters when she saw them in their own beds for the first time. She kissed her hand and placed it gently on each daughter’s forehead.

Now, the twin’s medical team will be focused on their recovery from the surgery.

“We still have a long way to go,” neonatologist Dr. Mary Frances Lynch said. “We are now shifting our focus to their immediate recovery, paying special attention to their wound healing and their pain control.”

Lynch said it was too early to speculate when the girls could return home.

Dr. Chad Barber, another neonatologist caring for the twins, said the immediate focus for the girls would be letting their lungs heal, and that there would be many steps before they could come off of oxygen support.

Conjoined twins are infants that are born with their bodies connected, and at least three out of every four conjoined twins are joined partially in the chest and share one or more organs with each other, according to the Children’s Hospital of Philadelphia.

Exact numbers of how many conjoined twins are born each year, and how many survive, are not known. Estimates vary widely, from 1 in every 30,000 live births to 1 in every 200,000 live births. Although the exact frequency is unknown, physicians do know that conjoined twins have small chances of survival.

Initially, Finley said he and Arciniega were daunted when they learned of their daughters’ diagnosis, about three months into the pregnancy.

“Why did God choose us to be these girls’ parents?” he said. “I prayed and had faith, and just had to walk through the steps.”

Finley later joked that the process had been like “walking through a haunted house. You just have to get through it, even through it’s scary, very scary.”

This was the first case of conjoined twins to be referred to Cook Children’s Medical Center, according to a spokesperson for the health system. The babies were born prematurely on Oct. 3 at Texas Health Harris Methodist Hospital Fort Worth, just across the street from Cook Children’s. Physicians and nurses at both hospitals worked together to coordinate care for the infants.

Even though the girls are just 16 weeks old, they’ve already developed distinct personalities despite sharing the same bed and body for most of their young lives, according to the girls’ parents and doctors. Jamie is the feisty one, never afraid to let someone know when she’s hungry or to wake up her sister, Finley said. Amie is quieter, and more laid back.

The girls’ parents haven’t been able to hold their daughters since the surgery.

But when they do, Finley joked, they’ll be a lot lighter.

This is a developing story. Check back for updates.