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Conjoined Twins Separated by Surgical Team at Children's Hospital of Pittsburgh of UPMC During Complex, 24-Hour Procedure

The twins were conjoined from the breast bone to the groin

PITTSBURGH, Feb. 16 /PRNewswire-USNewswire/ -- A multidisciplinary team of surgeons, pediatricians and nurses at Children's Hospital of Pittsburgh of UPMC has successfully separated conjoined twins during a 24-hour procedure.

The 2-year-old twin girls -- Dagian and Danielle Lee, of Cleveland -- were separated during a procedure that began at 6:30 a.m. Saturday, Dec. 13, 2008, and ended 24 hours later. The girls currently are recovering well at Children's Hospital.

The team that separated Dagian and Danielle was led by Joseph E. Losee, MD, FACS, FAAP, chief of the Division of Pediatric Plastic Surgery at Children's Hospital. He orchestrated more than 50 physicians and nurses who were either involved with the Lees' preoperative care or in the surgery itself. The surgical team consisted of specialists from Pediatric Anesthesiology, General and Thoracic Surgery, Orthopaedics, Plastic Surgery and Urology. Specialists from Cardiology, Critical Care Medicine, Nursing, the Paul C. Gaffney Diagnostic Referral Service and Pulmonology have also been involved in the twins' pre- and post-operative care.

The girls were conjoined from the breast bone to the groin. Among the many challenges facing the team was the fact that the twins shared a colon and had livers that were connected. They also shared a third leg.

"This complex separation was the culmination of 18 months of preparation and planning. The surgery itself went extremely well and we're very optimistic that Dagian and Danielle will continue their strong recovery," Dr. Losee said. "It's important to emphasize how remarkable it was to have more than 50 people working together in such a smooth and orchestrated fashion to ensure the best possible outcome for these two beautiful little girls. They still face future risks and surgeries, but we look forward to watching them live long, happy lives."

The twins spent the majority of their first two years of life as patients at Children's Hospital, undergoing more than 10 procedures during the 18-month period of preparation. The procedures included the placement of tissue expanders, which were used to stretch the skin to allow for reconstruction following the separation. They likely will require further reconstructive procedures in the future, according to Dr. Losee.

"It was such a difficult decision to make, and I knew the separation involved a very complicated surgery. I was scared, but I wanted the girls to be separated so they could give them the best life possible. When I met the team at Children's Hospital in Pittsburgh, I knew this is where we should come even though it is so far from my family and friends in Cleveland," said the girls' mother, Catherine Nickson. "The entire team has been amazing, and I can't thank them enough for all they've done for my girls."

Dagian and Danielle were ischiopagus twins, meaning they were joined at the pelvis and shared a colon. Conjoined twins are rare and occur in about one in every 100,000 births.

The team leaders from the various specialties involved in their separation are:

Timothy Kane, MD, FACS, FAAP -- Division of Pediatric General and Thoracic Surgery

Francis Schneck, MD -- Division of Pediatric Urology

Stephen Mendelson, MD -- Division of Orthopaedic Surgery

Franklyn Cladis, MD -- Division of Pediatric Anesthesiology

Sheila Willis, RN -- Perioperative Nursing

Megan Natali, PA-C -- Physician assistant in the Division of Pediatric Plastic Surgery

Patricia Dubin, MD -- Division of Pulmonary Medicine, Allergy and Immunology

For more information about Dr. Losee or the team, please visit

SOURCE Children's Hospital of Pittsburgh of UPMC
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