Conjoined Twins Recover from First Ever Separation Surgery at Vanderbilt

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2009-04-22 14:56

Three-month-old conjoined twins Keylee Ann and Zoey Marie Miller were separated in a complex operation on April 7 at the Monroe Carell Jr. Children's Hospital at Vanderbilt.

The surgery was the first of its kind at Vanderbilt and is believed to be the first successful separation of conjoined twins in Tennessee. It was carefully planned and carried out by a team of 30 medical, surgical and nursing personnel. "It was pretty exciting to finally get them separated," said Wallace (Skip) Neblett, M.D., lead surgeon. "We talked about this and planned it for months as the babies matured."

The girls were born Jan. 4 in Johnson City, Tenn., and were immediately transferred via LifeFlight to the Neonatal Intensive Care Unit (NICU) at Vanderbilt's Children's Hospital. Together, they weighed 4 pounds, 12 ounces. The twins were cared for in the NICU for the last three months until they grew strong enough for the separation surgery. The babies' parents, Victoria Ford and Brian Miller, knew early in the pregnancy that the twins were conjoined. They had hoped to carry them to term, but when Zoey and Keylee were in fetal distress, the girls were born by Caesarean section 10 weeks early.

Conjoined twins are identical twins who develop from the same fertilized egg. In the United States the incidence for conjoined twins is one per 200,000 live births. The girls were "omphalopagus" twins, fused from the lower breastbone to the navel. They shared a liver and part of a diaphragm, and were born with one umbilical cord.

On March 24, Zoey required surgery for a heart defect to provide her with better oxygenation so she would be stronger for the separation surgery. David Bichell, M.D., chief of Pediatric Heart Surgery, performed that operation, which required that Keylee go under general anesthesia as well. The heart surgery was a success, but somewhat complicated the care of the twins. Staff and faculty in the NICU devised systems to administer Zoey the medications she would need to recover from her heart surgery, without causing harm to Keylee. The twins shared a common circulatory system and would be exposed to the same medications.

By the day of the separation surgery, the twins weighed a combined 7 pounds, 10 ounces and were in good health.

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