Unbreakable Bond: The Inspiring Story of Separating Conjoined Twins Lily and Addy Altobelli
Conjoined twins, Addison (Addy) and Lilianna (Lily) Altobelli, achieved a remarkable milestone as they were successfully separated by a skilled surgical team at Children’s Hospital of Philadelphia (CHOP) on October 13, 2021. These adorable girls were born conjoined at the abdomen and chest, a condition known as thoraco-omphalopagus twins, which means they shared vital organs like the liver, diaphragm, chest, and abdominal wall.
The journey of Addy and Lily began when their parents, Maggie and Dom Altobelli, received the news during a 20-week ultrasound that they were expecting twins. To their surprise, the ultrasound revealed that the twins were not only two babies, but they were also conjoined at the abdomen.
Conjoined twins are rare, occurring in approximately 1 in 50,000 births. Given the complexity of the situation, the couple was referred to CHOP, one of the few hospitals in the country with expertise in separating conjoined twins. CHOP has successfully separated more than 28 pairs of conjoined twins since 1957, making it the leading hospital in this specialized field.
Maggie and Dom Altobelli consulted with specialists at CHOP’s Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment. After thorough evaluation, the medical team determined that while the girls shared a chest and abdominal wall, diaphragm, and liver, they had separate and healthy hearts. Moreover, their shared liver was large enough to be divided between them, making them ideal candidates for separation surgery.
After months of meticulous planning, a high-risk C-section delivery was performed on November 18, 2020, led by Dr. Julie S. Moldenhauer, in the Garbose Family Special Delivery Unit (SDU) at CHOP. Following their birth, Addy and Lily spent four months in the Newborn/Infant Intensive Care Unit (N/IICU) and another six months in the Pediatric Intensive Care Unit (PICU). Dr. David W. Low, a plastic surgeon at CHOP, inserted skin expanders to gradually stretch the girls’ skin, ensuring there would be enough to cover their exposed chest and abdomen after separation. These expanders, resembling small, collapsible balloons, gradually expanded over time through injections.
Finally, on October 13, 2021, after months of careful preparation, Addy and Lily underwent a remarkable 10-hour surgery. Led by Dr. Holly Hedrick, the surgical team consisted of over two dozen specialists, including general surgeons, anesthesiologists, radiologists, a cardiothoracic surgeon, and plastic surgeons. At 2:38 p.m., the twins were successfully separated. The surgical team then meticulously reconstructed each girl’s chest and abdominal wall. Dr. Stephanie Fuller, a cardiothoracic surgeon, ensured the proper positioning and functionality of both girls’ hearts while ligating their patent ductus arteriosus. Plastic surgeons placed two layers of mesh, one temporary and one permanent, over the girls’ abdominal and chest walls, followed by the skin that had been stretched over months.
On December 1, 2021, the Altobelli family finally returned home to Chicago, with one twin traveling at a time accompanied by one parent. After spending over a year in Philadelphia, the twins spent two weeks at Lurie Children’s Hospital under the care of their local medical team. Just in time for Christmas, the girls were discharged and arrived home to find their yard decorated by their thoughtful neighbors. They celebrated the holiday together as a family of four, cherishing the joy of being home.
The successful separation of Addy and Lily Altobelli not only represents a remarkable medical achievement but also signifies the strength
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