Separating Conjoined Twins with the Help of 3D Printing

Survival rates among conjoined twins are typically low. Separating the few of them that make it is only possible if they are not sharing vital organs, which they both need to survive. This was the situation Elysse Mata’s twin girls, Knatalye Hope and Adeline Faith, were facing. Until they were 10 months old, they were conjoined at the chest and abdomen, which included their chest wall, lungs, pericardial sac, diaphragm, liver, intestines, colon and pelvis.

Surgeons at the Texas Children’s Hospital started planning the highly-complex separation surgery nearly a year in advance. To visualize their intertwined organs, they used Materialise's Mimics Innovation Suite software to design a 3D-printed model based on high-quality CT scans which were designed to generate optimal contrast within the shared organs and the vasculature. Following computerized segmentation of the anatomy, the color-coded output was subsequently exported for 3D Printing and showed in great detail the babies’ heart, lungs, stomachs and kidneys, and where exactly they were connected.

“Having a 3D-printed model gives you an insight into what you’re going to encounter,” Dr. Rajesh Krishnamurthy, chief of radiology research and cardiac imaging at Texas Children’s Hospital, said in a video released by the hospital. “This type of surgical planning becomes very important when you decide to assign an organ to one twin or the other.” The key collaborators in this project were Mr. Nicholas Dodd, an advanced visualization expert at Texas Children’s Hospital, and Dr. Jayanthi Parthasarathy of MedCAD in Dallas, who supervised the 3D printing process.

In addition, the surgeons implanted tissue expanders into their torsos, stretching the skin ahead of the separation. The final surgery, which took nearly 30 hours and involved more than 26 clinicians of 13 different specialties, managed to successfully separate the two babies.

Materialise is unfamiliar with the 3D-printed model used in this case. When evaluating a 3D-printed device which is intended for the use in the diagnosis, or in the cure, mitigation, treatment or prevention of disease, where applicable, ensure that the manufacturer is registered or cleared with the FDA for distribution in the United States.