ʻO kahi hui ʻokiʻoki i komo i ʻoi aku ma mua o ʻelua mau kaukani kauka, me nā kauka lapaʻau maʻamau, anesthesiologists, radioologists, cardiothoracic surrgeon, a me plastic surrgeons, ua hoʻopau ma kahi o 10 mau hola e hoʻokaʻawale i nā kaikamahine. I ka wā i hoʻokaʻawale ʻia ai nā māhoe, ua māhele ʻia ka hui ʻokiʻoki i ʻelua a kūkulu hou i ka umauma o kēlā me kēia kaikamahine a me ka paia o ka ʻōpū, me ka hoʻohana ʻana i nā ʻenehana mesh a me nā ʻano hana ʻokiʻoki e hoʻopaʻa i kēlā me kēia pēpē.

"He mea paʻakikī ka hoʻokaʻawale ʻana i nā māhoe conjoined no ka mea ʻokoʻa kēlā me kēia pūʻulu māhoe, a he mau pilikia like ʻole lākou a me nā noʻonoʻo anatomic," i ʻōlelo ʻia ai ke kauā alakaʻi ʻo Holly L. Hedrick, MD, he kauka lapaʻau e hele ana i ka pediatric and fetal surgeon ma ka Division of Pediatric General , ʻO ka ʻoki ʻana o Thoracic a me Fetal ma ka Halemai o nā keiki o Philadelphia. "ʻO ke ʻano o kā mākou hui e hana pū ai, he mea kupaianaha a kūikawā, me ka nui o nā poʻe e hui pū nei e hana i kahi pahuhopu maʻamau. Ke hana maikaʻi nei ʻo Addy lāua ʻo Lily, a ʻo ko mākou manaolana e loaʻa iā lāua nā ola piha e hauʻoli.

Mai ka hōʻoia ʻana a hiki i ka lawe ʻana

Ua hoʻomaka ka huakaʻi a Addy lāua ʻo Lily i ka wā i ʻike ʻia ai lāua i ka wā ma mua o ko lāua koho ʻana i ka ultrasound 20-wiki. Ma mua o kēlā koho ʻana, ua manaʻo nā mākua ʻo Maggie lāua ʻo Dom Altobelli he keiki hoʻokahi lāua, akā ua hōʻike ʻia ke kiʻi ultrasound ʻaʻole wale ʻo Maggie e hāpai ana i ʻelua mau keiki hānai akā ua pili pū lāua ma ka ʻōpū.

He mea kakaikahi na māhoe hui, hiki mai ma kahi o 1 wale nō ma 50,000 hānau. Ua hāʻawi ʻia ka male i CHOP no ka loiloi hou ʻana, ʻoiai ʻo ka haukapila kekahi o nā mea liʻiliʻi ma ka ʻāina me ka ʻike e hoʻokaʻawale i nā māhoe conjoined. ʻOi aku ma mua o 28 mau māhoe conjoined i hoʻokaʻawale ʻia ma CHOP mai 1957, ʻo ka hapa nui o nā halemai ma ka ʻāina.

Ua hui nā kāne me nā loea ma CHOP's Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, kahi i hana ai ʻo Maggie i nā hoʻokolohua prenatal nui e hoʻoholo ai inā hiki ke hoʻokaʻawale i nā māhoe, e pili ana i ko lākou pilina a me ka anatomy like. Ua ʻike nā kauka ʻoiai ʻo nā kaikamahine i kaʻana like i ka umauma a me ka paia o ka ʻōpū, ka diaphragm, a me ke akepaʻa, ua ʻokoʻa nā puʻuwai olakino nā māhoe. Ua lawa nō hoʻi ka nui o ko lākou ate e hoʻokaʻawale ai i waena o lākou, e hoʻolilo iā lākou i mau moho maikaʻi loa no ke ʻoki kaʻawale.

Ma hope o nā mahina o ka hoʻolālā ʻana no ka hāʻawi ʻana i ka pilikia nui ma o ka C-section, alakaʻi ʻia e Julie S. Moldenhauer, MD, Luna Hoʻokele o Obstetrical Services, ua hānau ʻia ʻo Addy lāua ʻo Lily ma Nowemapa 18, 2020 ma ka Garbose Family Special Delivery Unit (SDU), ʻO ka hui lawe maʻi maʻi o CHOP. Ua noho lākou i ʻehā mahina ma ka Newborn/Infant Intensive Care Unit (N/IICU), a ukali ʻia e ʻeono mahina ma ka Pediatric Intensive Care Unit (PICU). Ua hoʻokomo ʻo David W. Low, MD, ʻo CHOP i nā mea hoʻonui ʻili e hoʻopololei i ka ʻili o nā kaikamahine i ka hoʻomākaukau ʻana no ke kaʻawale ʻana. E like me nā baluna liʻiliʻi liʻiliʻi, e hoʻonui mālie nā mea hoʻonui i ka ʻili ma o nā injections, e hoʻolohi mālie i ka ʻili i ka manawa i lawa ka ʻili o kēlā me kēia kaikamahine e uhi i kona paia umauma a me ka ʻōpū ma hope o ka kaʻawale ʻana.

He Opuu Pakiki

I ka wā i paʻa ai nā māhoe a ua lawa ka ʻili no ka uhi pono ʻana ma hope o ka hoʻokaʻawale ʻana, ua mākaukau lākou no ke ʻoki. He mahina ma mua o ka ʻoki ʻana, ua hui ka hui ʻokiʻoki i kēlā me kēia pule, e nānā hou ana i nā kiʻi ultrasound no ka nānā ʻana i ke koko i nā ate o nā kaikamahine, i hiki ai iā lākou ke hoʻokaʻawale i ke kahe o ke koko a i kahi i ʻaʻa ai nā ʻōpū o nā kaikamahine. Ua hoʻokumu nā radiologists CHOP i nā hiʻohiʻona 3D, i hui pū ʻia e like me nā ʻāpana Lego®, i hiki i ka hui ʻokiʻoki ke hoʻomaopopo i ka pilina o ka anatomy kaʻana like o nā kaikamahine a hoʻomaʻamaʻa i ke ʻoki ʻana i nā hoʻomaʻamaʻa hele wāwae, e like me ka hoʻomaʻamaʻa lole no ka lā o ke ʻoki.

Ma ʻOkakopa 13, 2021, ma hope o nā mahina o ka hoʻomākaukau ʻana, ua hana ʻo Addy lāua ʻo Lily i kahi ʻokiʻoki he 10 mau hola a ua hoʻokaʻawale ʻia ma 2:38 pm Radiology ma ka lima i ka wā o ke kaʻa ʻana e palapala i nā hale koʻikoʻi o ka ate me ka ultrasound. I ka wā i hoʻokaʻawale ʻia ai nā kaikamahine, ua māhele ʻia ka hui ʻokiʻoki i ʻelua a hana i ka hoʻopaʻa ʻana i kēlā me kēia kaikamahine a kūkulu hou i kona umauma a me ka paia o ka ʻōpū. Ua hoʻopaʻa ʻo Stephanie Fuller, MD, he kauka lapaʻau cardiothoracic, i ka patent ductus arteriosus o nā kaikamahine a ua hōʻoia i ka naʻau o nā kaikamahine ʻelua i ke kūlana kūpono a me ka hana maikaʻi. Hoʻonoho nā kauka lāʻau lapaʻau i ʻelua mau ʻanuʻu - hoʻokahi manawa, hoʻokahi paʻa - ma luna o ka ʻōpū a me nā paia umauma o nā māhoe a laila uhi ʻia me ka ʻili i hoʻohola ʻia i nā mahina ʻoiai nā kaikamahine i ka PICU.

I ka pau ʻana o nā kaikamahine i ka ʻoki ʻana, ʻike ʻo Maggie lāua ʻo Dom i kā lāua mau kaikamāhine i kaʻawale no ka manawa mua.

"ʻO ka ʻike ʻana iā lākou me ko lākou kino ponoʻī - maikaʻi loa ko lākou kino - he mea kupanaha," wahi a Maggie. "He mea hiki ʻole ke wehewehe ʻia."

Ka home no nā lā nui

Ma Kekemapa 1, 2021, ua lele hope ka Altobellis i ka home i Chicago - hoʻokahi māhoe i ka manawa, me hoʻokahi makua pākahi - ma hope o ka noho ʻana ma Philadelphia no hoʻokahi makahiki. Ua noho nā māhoe i ʻelua pule ma Lurie Children's Hospital ma lalo o ka mālama ʻana a ka hui lapaʻau e kākoʻo iā lākou kokoke i ka home. Ua hoʻokuʻu ʻia nā kaikamahine i ka manawa Kalikimaka a hōʻea i ka home e ʻike i ko lākou pā hale i kāhiko ʻia e ko lākou mau hoalauna. Ua hoʻomaha lākou i ka lā hoʻomaha ma ka home ma ke ʻano he ʻohana ʻehā.

Loaʻa iā Addy lāua ʻo Lily nā paipu tracheostomy a me nā ventilator e kōkua i ko lāua hanu ʻana, no ka mea, pono lākou i ka manawa e hoʻomohala ai i ka musculature a hoʻoponopono i ka hanu ʻana iā lākou iho. I ka manawa, e hoʻopau ʻia lākou mai nā ventilator.

"Ke hoʻomaka nei mākou i puke hou - ʻaʻole ia he mokuna hou, he puke hou ia," wahi a Dom. "Ua hoʻomaka mākou i puke hou no nā kaikamāhine, a aia kahi puke Addy, a aia kahi puke Lily."

He aha e lawe ʻia mai kēia ʻatikala:

A month before the surgery, the surgical team met every week, reviewing the ultrasound images again and again to study the blood supply to the girls’.
Once the twins had been separated, the surgical team divided in two and rebuilt each girl’s chest and abdominal wall, using layers of mesh and plastic surgery techniques to stabilize each infant.
Once the girls were separated, the surgical team divided in two and got to work stabilizing each girl and rebuilding her chest and abdominal wall.