Conjoined twin girls successfully separated at Columbus hospital

Nationwide Children’s Hospital doctors successfully separate conjoined twins
Acen (left) and Apio (right) Akello the morning before their separation surgery at Nationwide Children`s Hospital on Sept. 3, 2015. (pic courtesy Nationwide Children's Hospital)

COLUMBUS, Ohio (WCMH)– Conjoined twin girls were successfully separated during a 16-hour surgery at Nationwide Children’s Hospital last Thursday.

According to the hospital, the twin girls were joined at the pelvic and hip area and are recovering after the surgery on September 3.

The girls are named Acen and Apio, but on Thursday they were carefully labeled “blue” and “red” to help surgeons know which monitoring equipment belonged to each sister as they carefully separated their spines, muscle and tissue.

The surgery began at 7:30 a.m. on Thursday and concluded at 11:30 p.m. A surgical team of more than 30 specialists from pediatric surgery, plastic surgery, colorectal surgery, neurosurgery, anesthesiology and nursing performed the operation.

Acen and Apio Akello, the eleven-month-old daughters of Ester Akello of Uganda, were flown to Nationwide Children’s in December 2014. Earlier this year, they had surgery to have tissue expanders placed underneath their skin to prepare for their separation.

Two neurosurgeons focused on one sister each and yet assisted each other to delicately divide their intertwined spinal cords.

“Imaging helped guide our understanding of the twins’ anatomy,” explained Jeffrey R. Leonard, MD, chief of neurosurgery at Nationwide Children’s. “In the operating room we were able to visualize and discern which nerves belonged to which twin.  Our primary concern was preservation of the twins’ neurologic function so they may have adequate leg movement and bowel and bladder function once separated.”

Carefully dividing the soft tissue, Dr. Gail Besner, MD, chief of Pediatric Surgery at Nationwide Children’s was the surgeon who separated the twins. She took a brief moment away from operating to go to the waiting room to tell Ester that her children were no longer conjoined. Ester does not comfortably speak English, but no words were needed to convey her gratitude.

Although the girls were now on two separate tables, the surgery was still hours from being completed. The team that was formerly huddled around one operating table now huddled around two, and additional nurses and anesthesiologists were brought in to assist in the reconstruction.

It is not yet known how long Acen and Apio will remain at Nationwide Children’s before going home. They will both need to have one additional surgery to remove their colostomies, which they have had since shortly after birth.

Conjoined twins occur in about 1 in 200,000 pregnancies. Since 1978, surgeons at Nationwide Children’s have successfully separated four sets of conjoined twins, including the Akello sisters.

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