Happy Homecoming for Conjoined Twins After a Complex 6-Hour Separation Surgery

(Courtesy of Texas Children’s Hospital)

A set of conjoined twin girls are heading home with their parents after a successful separation surgery that involved a complex six-hour procedure requiring a total of 17 specialists in fetal medicine at one of the largest children’s hospitals in the United States.

Ella and Eliza Fuller were born via planned cesarean section to parents Sandy and Jesse Fuller at Texas Children’s Pavilion for Women on March 1. The babies were born at 35 weeks gestation and weighed an estimated 5 pounds 10 ounces (2.5 kilograms) each, according to a statement from Texas Children’s Hospital. They were conjoined at the abdomen and shared liver tissues.

An hour after delivery, Ella and Eliza were transferred to a level-4 neonatal intensive care unit (NICU) where they spent three months under expert care as part of the hospital’s Conjoined Twin Clinical Program, while their team prepared for separation surgery on June 14. In early July, the twins went home to meet their big sister, Emilia, to begin their happy, healthy lives as two separate babies.

“From the beginning to the end we were guided, informed, and comforted,” Ms. Fuller said. “We are so grateful God put some of the best doctors and nurses in our lives to give our girls the best chance at life.”

Ella and Eliza when they were born. (Courtesy of Texas Children’s Hospital)

Mr. and Ms. Fuller with their newborn children. (Courtesy of Texas Children’s Hospital)

The twins’ six-hour surgery was conducted by seven surgeons, four anesthesiologists, four surgical nurses, and two surgical technicians led by Dr. Alice King, a pediatric surgeon at Texas Children’s Hospital and Assistant Professor of Surgery, Division of Pediatric Surgery at Baylor College of Medicine. The surgery went quicker than expected, according to Dr. Larry Hollier, Surgeon-In-Chief at Texas Children’s Hospital and Vice Chair of Surgery at Baylor College of Medicine, owing to the team’s “expertise, extensive planning, and seamless collaboration.”

After the surgery, Ella and Eliza returned to the NICU and recovered quickly. They were extubated three days later, allowing their parents to hold their baby girls separately for the first time in their lives.

(Courtesy of Texas Children’s Hospital)

(Courtesy of Texas Children’s Hospital)

Ms. Fuller first learned that she was expecting conjoined twin girls during a routine ultrasound in her second trimester. She was referred to Texas Children’s Fetal Center, where prenatal testing and imaging determined that her babies could be separated after birth.

Ms. Fuller received specialized prenatal care, and the team led by Dr. King ran simulations for the procedure, weeks ahead of the six-hour surgery on June 14.

“Conjoined twin pregnancies are incredibly rare and very high-risk,” said Dr. Roopali Donepudi, a maternal-fetal medicine specialist at Texas Children’s Pavilion for Women and Associate Professor of Obstetrics and Gynecology at Baylor College of Medicine, who prepared the delivery team ahead of the twins’ birth. “The prenatal testing and imaging ... informed not only the labor and delivery team to ensure that mom and babies had the best birth outcome, but also allowed our neonatal and surgery colleagues to begin planning for the twins’ care while still in utero.”

Ella and Eliza are on the way to their surgery. (Courtesy of Texas Children’s Hospital)

(Courtesy of Texas Children’s Hospital)

Mr. and Ms. Fuller holding both their babies. (Courtesy of Texas Children’s Hospital)

Dr. Jonathan Davies, a neonatologist at Texas Children’s Hospital and Assistant Professor of Pediatrics at Baylor College of Medicine, said that every set of conjoined twins “poses unique challenges,” and Ella and Eliza were no exception. Yet their personalized treatment plan, from delivery to surgery and beyond, has allowed the babies to reach the “very exciting milestone of getting to go home.”

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