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Doctors Separate Conjoined Twin Girls

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Doctors Separate Conjoined Twin Girls

 Conjoined Twins: Abbigail And Isabelle Carlsen Before Surgery

ROCHESTER, Minn. (AP) ― After nearly seven hours of surgery to untangle their livers, reposition their hearts and divide a shared intestine, twin girls Abbigail and Isabelle Carlsen were separated Friday by a team of doctors at the Mayo Clinic.

The sisters were joined at the chest and abdomen since birth and spent their first five months looking eye to eye, often bumping legs and arms and touching each other in the face.

The separation lasted almost seven hours. By Friday night, the girls were sleeping in separate beds, in adjoining rooms.

"We expect them to have a smooth night, but they are critically ill and we expect them to stay that way for the next 24 to 48 hours," said Dr. Christopher Moir, the lead surgeon.

He said the girls can hopefully come off a ventilator and perhaps begin waking up after that.

When the girls were born Nov. 29, to Amy and Jesse Carlsen of Fargo, N.D., they were joined at the diaphragm, pancreas and liver, and they shared a common bile duct and part of an intestine.

"If any of you looked outside today, you noticed it was cloudy and rainy and the sun was nowhere to be seen," said Jesse Carlsen. "I think that's because it was in that operating room, with our girls and this team. And today all of our prayers have been answered, and I can't thank you enough for helping our girls."

Since February a Mayo Clinic team of 70 people had been caring for the girls and preparing for Friday's separation. A team of 30 people, including 18 surgeons, participated in the tightly orchestrated operation, with specialists rotating in and out of the operating room as needed.

The separation surgery was like one major surgery after another.

Early Friday morning, Amy and Jesse Carlsen helped take their daughters to the operating room. Anesthesia was administered and the doctors made the first incision at 9:44 a.m.

After the procedure began, doctors confirmed the girls had two separate hearts. Medical imaging done in the weeks before the surgery showed Isabelle's heart was tipped into her sister's body and would have to be moved. Mayo spokesman Lee Aase said Isabelle's blood pressure remained stable as her heart was maneuvered into her own chest cavity.

Doctors also removed both of the girls' gall bladders during the procedure, so the drainage systems in the organs could be rerouted, Aase said.

Aase said that after the girls' livers were separated, the medical team applauded, having completed one of the more complicated parts of the operation. The liver separation was difficult because of the way the organs were fused and because the circulatory structures inside the livers needed to be divided correctly.

Isabelle retained the common bile duct, and doctors constructed a biliary structure for Abbigail.

The length of their intestines was a concern, too.

"It was possible that they would not have enough intestine to lead a normal life," Moir said.

But doctors found enough, 90 centimeters, and divided it evenly between the two girls.

Doctors had estimated there was a 90 percent to 95 percent chance that both girls would survive.

"The girls did great. The credit goes to them. I think they are tough little girls," said Dr. Randall Flick, their anesthesiologist.

Moir said he'd never met "parents who have been stronger, more courageous, more willing to listen, who trusted us implicitly, who followed along every step of the way, asked great questions."

"You guys entrusted your little girls to us. You have been there and back."

(© 2006 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)

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