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Twins are born conjoined at major organs, are separated in a 26-hour historic surgery

In early February of 2015, a group of more than 26 clinicians from the Texas Children’s Hospital embarked on a medical journey that had never been successfully completed: separating two thoraco-omphalo-ischiopagus conjoined twins. 


The twins, Knatalye Hope and Adeline Faith Mata, had been born in April of 2014, sharing several major organs, including lungs, liver, intestines, colon, pelvis, chest walls, diaphragm, and pericardial sac (heart lining). In the end, their parents and doctors ultimately agreed that a separation would be the best course of action.

Doctors created models of the girls’ organs, using them to run practice trials and simulations before attempting the actual operation.

Pediatric surgeon Dr. Darrell Cass explained, “Our team has been preparing for this surgery for months and we’ve done everything from working with our radiology experts to build a 3-D model of [the girls’] organs, to conducting simulations of the actual separation surgery.”

When it came time for the surgery, a team consisting of 12 surgeons, 6 anesthesiologists, and 8 surgical nurses were charged with the difficult task.

The entire process is reported to have taken about 26 hours, with doctors spending 23 hours on Knatalye and 26 hours on Adeline. The official separation occurred at the 18-hour mark.


The operation was deemed a success, with no large issues arising through its entirety. Following the procedure, Dr. Darrell Cass told the parents that the twins were “stable as can be, breathing well, blood pressure is great… [and] the entire chest is completely closed.”


Dr. Cass has since spoken of the surgery, saying, “Seeing the girls wheeled out of the operating room as separate patients, on separate gurneys, the ramifications for them to live private lives was even more poignant and powerful than I expected. It literally brought tears to my eyes”.

The team is no doubt proud of their work, with Dr. Cass reminding us, “This is the first time a separation surgery for thoraco-omphalo–ischiopagus twins with this particular configuration has been successful.” Overall, he notes that the staff was “very pleased with how they’re doing” and “very optimistic that they will both have a really great outcome”.

Following the procedure, mother Elysse expressed her thanks and appreciation, stating, “We know how much planning and time went into this surgery and we are so blessed to be at a place like Texas Children’s where we have access to the surgeons and caretakers that have made this dream a reality”

February 2016 officially marked the 1-year anniversary of Knatalye and Adeline’s separation. Very few updates regarding the girls have been made available; however, parents Elysse and John have publically stated that both are thriving and beginning to develop their own little personalities, something that would have been much less likely without the hard work and dedication exhibited by the talented surgery team at the Texas Children’s Hospital.


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