A Tale of Triumph: The Incredible Separation of Conjoined Twins Addy and Lily Altobelli at CHOP

On October 13, 2021, a remarkable milestone was achieved at the Children's Hospital of Philadelphia (CHOP) as surgeons successfully separated conjoined twins Addison (Addy) and Lilianna (Lily) Altobelli. These courageous girls were joined at the abdomen and chest, facing the challenges of being thoraco-omphalopagus twins, sharing vital organs like the liver, diaphragm, chest, and abdominal wall.

A Journey of Discovery: Addy and Lily's Extraordinary Path as Conjoined Twins

The incredible story of Addy and Lily began with a life-changing prenatal diagnosis during their 20-week ultrasound. To their surprise, Maggie and Dom Altobelli, expecting a single baby, discovered that they were carrying two fetuses conjoined at the abdomen.

Conjoined twins are a rarity, occurring in just approximately 1 in 50,000 births. Seeking specialized care, the couple was referred to the renowned Children's Hospital of Philadelphia (CHOP), known for its expertise in separating conjoined twins. With a legacy spanning since 1957, CHOP has successfully separated over 28 pairs of conjoined twins, making it the foremost hospital in the country for such complex procedures.

A Journey of Hope: Addy and Lily's Extraordinary Path to Separation

Upon their arrival at the Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment at CHOP, Maggie and Dom met with a team of specialists. Extensive evaluations revealed that while Addy and Lily shared a chest, abdominal wall, diaphragm, and liver, they had individual, healthy hearts. Additionally, their shared liver was sufficiently large to be divided between them, making them ideal candidates for separation surgery.

Months of meticulous planning for a high-risk delivery via C-section ensued under the guidance of Dr. Julie S. Moldenhauer. Finally, on November 18, 2020, in the Garbose Family Special Delivery Unit (SDU) at CHOP, Addy and Lily were born. Their journey continued in the Newborn/Infant Intensive Care Unit (N/IICU) for four months, followed by an additional six months in the Pediatric Intensive Care Unit (PICU). In preparation for the separation surgery, CHOP's plastic surgeon, Dr. David W. Low, inserted skin expanders to gradually stretch the girls' skin, ensuring there would be enough to cover their exposed chest wall and abdomen post-separation. These expanders, resembling small, collapsible balloons, were incrementally filled through injections, allowing the skin to stretch over time.

The Miraculous Separation: Addy and Lily's Triumph on October 13, 2021

After months of meticulous preparation, Addy and Lily embarked on a remarkable 10-hour surgery that would forever change their lives. Led by the skilled hands of Dr. Holly Hedrick, a team of over two dozen specialists, including general surgeons, anesthesiologists, radiologists, a cardiothoracic surgeon, and plastic surgeons, united their expertise for this monumental task. At 2:38 p.m., the twins were successfully separated, marking a momentous milestone in their journey.

With the twins now separated, the surgical team embarked on the intricate process of reconstructing each girl's chest and abdominal wall. Dr. Stephanie Fuller, a gifted cardiothoracic surgeon, meticulously ligated the girls' patent ductus arteriosus and ensured that both of their hearts were properly positioned and functioning optimally. Plastic surgeons skillfully placed two layers of mesh, one temporary and one permanent, over the girls' abdominal and chest walls. Finally, the skin that had been gradually stretched over months was delicately positioned to provide coverage, completing the transformative surgery.

A Heartwarming Homecoming: Addy and Lily's Joyful Return to Chicago

After over a year of residing in Philadelphia, the Altobellis were finally able to embark on their journey back to Chicago on December 1, 2021. The homecoming was a gradual process, with one twin traveling at a time accompanied by one parent. Upon their arrival, the twins received exceptional care at Lurie Children's Hospital, where the dedicated medical team, poised to support them closer to home, ensured their well-being for two weeks. Just in time for Christmas, the girls were discharged, stepping foot into a yard adorned with festive decorations lovingly put up by their neighbors. As a family of four, they embraced the holiday season, cherishing precious moments spent together in the warmth of their own home.