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Separated Twins Doing Well at Children's Hospital

Separated Twins Doing Well at Children's Hospital

Catherine Nickson fixes her daughter Dagian Lee's dress while her other daughters Danielle Lee. (Michael Henninger/Post-Gazette)

David Templeton / Pittsburgh Post-Gazette

February 18, 2009

Successful separation of twins, conjoined from the breastbone to the groin, has occurred only 20 times in the world and never before at Children’s Hospital of Pittsburgh of UPMC.

But in December, a team of 50 doctors and nurses from Children’s — including general and orthopedic surgeons, anesthesiologists and experts in plastic surgery, urology and organ systems — separated 2-year-old twins Dagian and Danielle Lee of Cleveland during a 24-hour surgical marathon.

Two months later, the two are brimming with personality and intelligence. Both playful, Danielle is outgoing, while Dagian can display a temper.

“They are happy, healthy and will be discharged soon,” said Dr. Joseph E. Losee, chief of the Division of Pediatric Plastic Surgery at Children’s.

Dr. Losee, who led the effort, said the operation required professionals to work together in smooth, orchestrated fashion to ensure the best outcome “for these two beautiful little girls.”

Future reconstructive surgeries will be necessary, but the girls seem happy to be separated while remaining close in spirit. Each has only one leg, without the hip or leg-bone structure necessary for the typical prosthetic leg. Doctors said their chances of getting a prosthesis is 50-50. Until that decision is made, they’ll use wheelchairs.

“They are typical little girls,” their mother, Catherine Nickson, 26, said.

While conjoined, they’d grab each other’s pacifiers, bop each other on the head with toys, and fight, play and laugh together. Now on intravenous treatments in separate beds, they interact from afar and talk to each other on cell phones.

“I think they are happy they can go to sleep without the other punching her in the face,” said Ms. Nickson, who has lived since October 2007 with her 3-year-old, Dayloni, at the Ronald McDonald House.

She said she decided on the separation surgery because she “wanted three kids, not two or one.”

Doctors prepared for the separation for 18 months, with the twins undergoing 10 advanced procedures, including insertion of tissue expanders to stretch the torso skin so it could cover the surgical openings half the size of their torsos and pelvises. Because the rib cages were connected, the girls also had respiratory problems that had to be resolved before the separation surgery.

The University of Maryland Medical Center says one in every 200,000 births involves conjoined twins. Up to 60 percent are stillborn, and up to 25 percent survive.

Conjoined twins usually are identical and the same sex, most often female. Their individual embryos conjoin three or four weeks in utero and often develop common internal organs. Commonly called Siamese twins, they can share brains, hearts, limbs and various internal organs.

Dagian and Danielle were ischiopagus twins, which accounts for 6 percent of all conjoined births. Such twins are joined at the pelvis, which means they can share a gastrointestinal tract, genitalia and urinary tract organs.

“Only 20 in the world like this have been separated,” said Dr. Timothy Kane of Children’s Division of Pediatric General and Thoracic Surgery.

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