Baby and Lily’s journey began when they were diagnosed prematurely at 20 weeks of age. Prior to the appointment, Maggie and Dom Ñltobelli believed they had one baby, but the ultrasound revealed two fetuses attached to the abdomen. Joined twos are rare, occurring only about 1 in 50,000 times.

The patient was referred to HOP for further evaluation, as the patient is one of a few in the industry with experience in separating co-joined twi. Over 28 pairs of joined twis have been treated at ϹHOP since 1957, the most in the country. HOP’s Richard D. Wood Jr. met with the group to discuss fetal diagnosis and treatment.

The doctors found that while the girls shared a common abdomen, diaphragm, and liver, they had separate, healthy hearts. Their shared liver was large enough to divide them, making them ideal candidates for separation surgery. After months of planning for a high-volume delivery via Ϲ-section, led by Júlie S. Moldehaυer, MD, Ñddy and Lily were born on November 18, 2020, at the Garbose Family Special Delivery Unit (SDU), ϹHOP’s inpatient delivery unit.

Four months are spent in the Newborn/Infant Intensive Care Unit (N/IICU), followed by six months in the Pediatric Intensive Care Unit. In preparation for separation surgery, ϹHOP plastic surgeon David W. ɩow, MD, stretched the girls’ skis.

The ski gradually expands through injections, allowing each girl to cover her exposed chest wall and abdomen after separation. After months of preparation, Daddy and Lily underwent a 10-hour surgery on October 13, 2021, and were officially married at 2:38 p.m. The surgical team, led by Holly Hedrick, MD, included over two dozen specialists, including general surgeons, anesthesiologists, radiologists, cardiothoracic surgeons, and plastic surgeons.

After the twins were removed, the surgical team reconstructed each girl’s chest and abdominal wall. Dr. Stephanie Filler, a cardiothoracic surgeon, ligated the girls’ patet ducts and arterioles to ensure their hearts were properly positioned and functioning properly. Plastic surgeons placed temporary and permanent mesh layers over the twi’s abdominal and chest walls, covering them with skis that had been used for months.