Dec
23
2014

Mata conjoined twins take first step toward separation with tissue expansion

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Conjoined 8-month-old twin girls, Knatalye Hope and Adeline Faith Mata, underwent a five-hour surgery December 16 at Texas Children’s Hospital Main Campus to place custom-made tissue expanders into their chest and abdomen area. The tissue expanders will help stretch the babies’ skin in preparation for their separation surgery, which is expected to take place early next year.

During their recent surgery, the infants also had an examination to help assess their anatomy and the placement of PICC catheters in preparation for the twins’ separation. Dr. Alberto Hernandez with Interventional Radiology performed the examination. Chief of Plastic Surgery Dr. Larry Hollier and Dr. Ed Buchanan with the Division of Plastic and Reconstructive Surgery conducted the tissue expander placement surgery. Dr. Helana Karlberg led the anesthesia team and Audra Rushing led the surgical nursing team.

“We are pleased the babies did so well during the surgery,” Hollier said. “A multidisciplinary team continues to monitor them in our neonatal intensive care unit as they recover.”

The tissue expander placement surgery requires a recovery time of six to eight weeks, during which additional fluid will be added to the tissue expanders, which are like balloons, to allow the skin to be stretched gradually. The extra skin is needed to provide coverage once the babies are separated.

During the girl’s recovery, the planning process for the separation surgery will continue among a team of multidisciplinary specialists in pediatric surgery, urology, plastic surgery, orthopedic surgery, cardiovascular surgery and pediatric gynecology.

“We have been preparing for the twins’ separation surgery for months and the process is ongoing,” said Dr. Darrell Cass, pediatric surgeon and co-director of Texas Children’s Fetal Center. “In addition to multidisciplinary meetings, our plans have included, among other things, building a 3-D model of their organs, conducting simulations of the surgery and post-operative care they will receive, as well as helping create devices to support their care, such as a swing which will hold the girls upright to alleviate pressure on their healing incisions.”

Anticipated to take approximately 24 hours, the separation surgery will involve two teams of surgeons who will work together to separate the twins, who share a chest wall, lungs, pericardial sac (the lining of the heart), diaphragm, liver and pelvis. The separation team will start the surgery and the reconstruction team will complete the procedure.

Surgeons at Texas Children’s Hospital in 1992 successfully separated Tiesha and Lesha Turner, who were 1 year old and shared a sternum, liver, entwined intestines and fused organs. The separation of Knatalye and Adeline will be the second such procedure performed at the hospital.

Cass said he expects the surgery to go well and for each child to be able to live independently and to have a good life.

Knatalye and Adeline were born April 11 at Texas Children’s Pavilion for Women. Delivered via Caesarean-section at 31 weeks gestation, the twins each weighed 3 pounds, 7 ounces.

The girls’ parents, Elysse and John Mata, and their 5-year-old brother, Azariah, learned during a routine ultrasound on Jan. 13 that Elysse was carrying twins and they were conjoined. Subsequently, the family was referred from a physician in Lubbock, their hometown, to the Texas Children’s Fetal Center where they underwent extensive prenatal imaging, multidisciplinary consultation and development of plans to achieve a safe delivery and postnatal care.

Now 8 months old, the babies weigh about 15 pounds each and are doing well as they continue to be cared for by a team of specialists in the Level IV neonatal intensive care unit at Texas Children’s Hospital.

Elysse Mata said the day before the tissue expander placement surgery she is confident her girls are in good hands at Texas Children’s Hospital.

“I have an extreme amount of faith in the team at Texas Children’s and in God,” she said. “I know He put us here for a reason.”