N.D. conjoined twins separated

The head of the medical team that separated five-month-old conjoined twins from North Dakota on Wednesday proclaimed the operation flawless.

Dr. Christopher Moir said Abygail and Madysen Fitterer _ who were born joined at the chest _ were both doing very well following about seven hours of surgery at the Mayo Clinic.

"This is Day 99 of their hospital stay. It is also Day 1 of their beautiful, separate lives," Moir said at a news conference attended by the girls' parents, Stacy and Suzy Fitterer, of Bismarck, N.D.

The girls rode into the operating room on the lap of their mother, who sat in a wheel chair, just before 7 a.m. Surgeons made the first incision around 9:50 a.m.

A video released by Mayo showed the surgical team applauding as the girls were placed on separate operating tables at 12:27 p.m. Doctors then went about the challenging work of reconstructing their chest walls. They finished with Madysen at 3:36 p.m. and with Abygail at 4:05 p.m., Moir said.

Moir also led the teams that separated conjoined twin girls from Fargo, N.D., in May and twin boys from Mankato in November.

The Fitterer twins have been at Mayo since doctors implanted tissue expanders in October to slowly stretch the girls' skin enough to close their incisions from the separation surgery.

Doctors said the most difficult part of the procedure was separating and reconstructing the girls' chest walls and closing their chests over their hearts. Moir said the girls shared one liver that, fortunately, had two drainage systems. He also was pleased to report that they didn't share any intestines, which doctors had initially feared.

The parents posted a tribute to Abygail, Madysen and their two-and-a-half-year-old son, Nicholas, on Wednesday on the family's Web page at http://www.caringbridge.org.

"Dear Nicky, Abby and Maddy: Thank you so much for the pure joy and pleasure you have given us," they wrote. "You have taught us the importance of living, truly living each day and loving the 'big' days and the 'little' days."

This was Mayo's fifth separation of conjoined twins. Besides the two sets last year, Mayo did two other separations around 10 years ago.

According to Mayo experts, conjoined twins may develop in as many as one in 50,000 pregnancies, but they account for only one in about 250,000 live births.

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On the Net:

Mayo Clinic: http://www.mayoclinic.org/fitterer-twins