0:00:06.000,0:00:09.000 Chelsea and Maggie are our two conjoined twins. 0:00:09.000,0:00:15.000 They’ve traveled to us from Sierra Leone for the explicit purpose of being separated. 0:00:15.000,0:00:17.000 They’re now five months old. 0:00:17.000,0:00:22.000 My daughters, this is Maggie and this is Chelsea. 0:00:22.000,0:00:28.000 They like to sleep. 0:00:28.000,0:00:36.000 If we’re looking at the babies, now, we can see that they’re connected here across their abdomen and they’re going to be separated here across their abdomen. 0:00:36.000,0:00:41.000 Seeing two conjoined twins that are healthy that are appropriate for separation is extremely rare. 0:00:41.000,0:00:50.000 The entire experience in the literature is limited in terms of how many of these operations have actually been done. 0:00:50.000,0:01:08.000 Chelsea and Maggie are primarily joined at the chest wall and at the abdomen. Anatomically that the most likely areas where they’re going to be joined is certainly at their liver and potentially also at their breast bone and their pericardium, which is the lining around the heart. 0:01:08.000,0:01:15.000 We knew that we would need to create more skin and soft tissue in order to have adequate coverage over their organs after we separated them. 0:01:15.000,0:01:38.000 And so six weeks ago, we placed tissue expanders underneath their skin and began a process of slow expansion of the soft tissue envelope and we are setting the stage for what will be a very big day, but a very good day where we’re hoping to separate them successfully tomorrow. 0:01:38.000,0:01:40.000 In July 2018, I got married. 0:01:40.000,0:01:48.000 My lovely wife gave birth to three babies. The boy was separated, the two girls was conjoined. 0:01:48.000,0:01:55.000 When my children born, I feel excited why I see them. 0:01:55.000,0:02:03.000 I was thinking about their separation, whether they are going to separate or not. 0:02:03.000,0:02:10.000 Unfortunately, I lost my son after a couple of weeks in the hospital in Sierra Leone. 0:02:10.000,0:02:13.000 There was really a big devastation for the family. 0:02:13.000,0:02:18.000 That’s when they really wanted to go seek medical care outside. 0:02:18.000,0:02:28.000 I want my babies going well, play, and have a successful life and happy life. 0:02:28.000,0:02:37.000 When they are separated. We know we are going to be a super happy family. 0:02:37.000,0:02:43.000 This morning begins the day of separation. 0:02:43.000,0:02:47.000 You know, we are prepared. We are ready for any unexpected event. 0:02:47.000,0:02:49.000 I’m really excited for the family. 0:02:49.000,0:03:09.000 This is really going to play out we hope as a well coordinated symphony where we’re going to culminate with each person doing their portion and using their expertise to create this separation. 0:03:09.000,0:03:11.000 How are you this morning? 0:03:11.000,0:03:26.000 First several hours will be the delivery of anesthesia and the monitoring and then the separation will begin. It will take several hours and the reconstruction will take an additional several hours. So we’ll go most of the day today. 0:03:26.000,0:03:32.000 We are about to start the split. 0:03:32.000,0:03:38.000 The first thing that will need to happen will need to actually be a separation of their breast bone or their sternum. 0:03:38.000,0:03:44.000 And then we’re going to get to the point where we’re going to have to do a separation of the lining of the heart. 0:03:44.000,0:03:51.000 And so that’s going to be Doctor Bosch’s job to separate any of the cardiac contents. 0:03:51.000,0:03:56.000 After that, we’re going to work our way down into the intra-abdominal area. 0:03:56.000,0:04:04.000 And so at that time, Doctor Tom Cato from our liver transplant team will take the lead. 0:04:04.000,0:04:08.000 There’s only one organ that is really clearly fused is the liver. 0:04:08.000,0:04:10.000 And it’s not a really small portion. 0:04:10.000,0:04:22.000 It’s a very big portion of the liver is fused. So we have to split into two parts.[br]Start visual description. Censored video of liver being separated in the surgery. End visual description. 0:04:22.000,0:04:33.000 So then the next part of the surgery, Doctor Stylianos and I will take the lead and we’ll do the final separation of the rest of the soft tissue envelope. 0:04:33.000,0:04:46.000 We then had a magical moment where we took the two girls which were sharing one table and we now brought them to two separate tables being the first time that they were physically in a separate space. 0:04:46.000,0:04:49.000 The twins have been separated there. 0:04:49.000,0:04:50.000 We still have a fair amount of work to do. 0:04:50.000,0:04:56.000 We’ll update you as we’re going along, but we wanted to deliver that piece of information. 0:04:56.000,0:04:57.000 They were cheering. 0:04:57.000,0:05:01.000 I was so overjoyed. I don’t know what to say. 0:05:01.000,0:05:06.000 When I hear my girls separated. 0:05:06.000,0:05:30.000 We now in a sense, had two simultaneous operations that were ongoing. As we have known and as we suspected all along, although the two girls were conjoined, they are not made equally. On the one table. Doctor Basha and his team assisted by Doctor Kato began the process of trying to actually get Chelsea’s left ventricle to sit within her chest. 0:05:30.000,0:05:43.000 Myself and my team along with Doctor Stylianos was taking the lead on beginning the closure process for Maggie. 0:05:43.000,0:06:01.000 We brought the both girls up to the ICU. 0:06:01.000,0:06:12.000 Well, the day of the surgery, we go and see them separated different beds. Oh, we are so happy at that moment. 0:06:12.000,0:06:16.000 We shared a hug with the parents. 0:06:16.000,0:06:18.000 Thank you. Thank you so much. Thank you. 0:06:18.000,0:06:40.000 Thank you very much. 0:06:40.000,0:06:48.000 They are doing great because now they move, they stand for themselves, they walk a little bit. 0:06:48.000,0:06:52.000 So they are doing well now. 0:06:52.000,0:06:56.000 You know, this whole experience I would say has been so gratifying. 0:06:56.000,0:07:10.000 It was amazing to see this young, young couple display such bravery and bringing their children here for us to take care of and really trusting that we have the correct expertise here to do so. 0:07:10.000,0:07:24.000 There are definitely two different girls. Chelsea, though she may be the smaller one, had a lot of spunk to her and had a lot of strength and Maggie seemed a little more domicile and a very, very smiley little baby. 0:07:24.000,0:07:31.000 It’s just remarkable to see the two kids and to see the dynamic between them and the parents. 0:07:31.000,0:07:46.000 My kids are separated now. They have to live a normal life like the other kids. So I happy with my lovely wife so much because we went through a lot before the separation. 0:07:46.000,0:07:52.000 We give thanks and appreciation to each and everyone in this hospital. 0:07:52.000,0:07:58.000 The way we see them playing together, they are having new life right now. 0:07:58.000,0:08:02.000 They’re feeling good to be so happy about that. 0:08:02.000,0:08:03.000 I want them to be healthy and better life like the other kids are because they are different now, everything will be ok.