CT Imaging, 3D Printing Helped Doctors Separate Conjoined Twins In 26-Hour Surgery
The story of Faith and Hope Mata, identical twins who were born extremely conjoined, is truly an inspiring tale of faith and hope.
Doctors at the Texas Children's Hospital successfully separated the twins during a 26-hour surgery in February 2015, and they recalled how the use of CT imaging and 3D printing helped them plan the surgical process.
In a study presented at the annual meeting of the Radiological Society of North America (RSNA), specialists explained that they completed a volumetric CT imaging scan on the conjoined twins to enhance views of each child's essential structures. The CT scan helped the doctors ensure the survival of both children.
Through a method known as target mode prospective ECG gating, the doctors froze the motion of the twins' hearts on images so they could get a detailed view. They used intravenous contrast dye to enhance views of the twins' cardiovascular anatomy while keeping radiation exposure low.
Faith and Hope had a condition called thoraco-omphalo-pyopagus in which they were conjoined from their chest all through their pelvis, doctors said.
Dr. Rajesh Krishnamurthy, one of the researchers of the study, said that the hearts of the twins were located in the same cavity but were not fused. He and his colleagues also detected a plane of separation in the twins' liver that surgeons would be able to use.
The team of specialists then transformed the CT images into color-coded 3D models with physical and skeletal structures made from rubber-like material and hard plastic resin. The livers were printed as separate parts with major blood vessels represented in white so they could be better seen. These physical models could be separated or assembled together during the planning of the surgical process.
Doctors used these models up until the day of the surgery. The 10-month-old twins went through a surgical separation conducted by a group of more than 26 clinicians, in which there were six anesthesiologists, eight surgical nurses and 12 surgeons. The official separation occurred 18 hours into the operation, with no surprises because of the information in the 3D models, he said.
"It was one of the most complex separations ever for conjoined twins," recalled Krishnamurthy.
In May 2015, Knatalyne Hope Mata returned home. Her twin sister, Adeline Faith Mata, was sent home in June 2015. According to their Facebook page, the twins are now doing well.