Conjoined twins Addison (Addy) and Lilianna (Lily) Altobelli underwent a successful separation surgery at the Children’s Hospital of Philadelphia (CHOP) on October 13, 2021. The twins were born conjoined at the abdomen and chest, a rare condition known as thoraco-omphalopagus twins, where they shared vital organs including the liver, diaphragm, chest, and abdominal wall.
The journey of Addy and Lily began with a prenatal diagnosis at the 20-week ultrasound, where their parents, Maggie and Dom Altobelli, discovered they were expecting conjoined twins. Recognizing the complexity of their situation, the couple was referred to CHOP for further evaluation, given the institution’s extensive experience in separating conjoined twins, with over 28 successful separations since 1957.
Upon consultation with specialists at CHOP’s Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, it was determined that the twins, although sharing critical anatomical structures, had separate and healthy hearts. Their shared liver was also deemed suitable for division, making them strong candidates for separation surgery.
Following months of meticulous planning, Addy and Lily were born on November 18, 2020, at CHOP’s inpatient delivery unit. They spent several months in the Neonatal/Infant Intensive Care Unit (N/IICU) followed by a six-month stay in the Pediatric Intensive Care Unit (PICU). In preparation for the separation surgery, CHOP plastic surgeon David W. Low inserted skin expanders to gradually stretch the twins’ skin, ensuring there would be sufficient coverage for their exposed chest and abdominal walls post-surgery.
On October 13, 2021, after intensive preparation, Addy and Lily underwent a 10-hour separation surgery led by Dr. Holly Hedrick, which involved a multidisciplinary team of over two dozen specialists. Following the successful separation, each girl’s chest and abdominal walls were reconstructed, with careful attention given to the positioning and function of their hearts. The surgical team utilized temporary and permanent mesh, along with the stretched skin, to reconstruct the twins’ chest and abdominal walls.
On December 1, 2021, the Altobelli family returned home to Chicago after over a year in Philadelphia, with the twins receiving further care at Lurie Children’s Hospital in their hometown. The twins’ discharge coincided with the holiday season, and they arrived home to a festive yard decorated by their neighbors, celebrating the family’s reunion and the twins’ newfound independence.
The successful separation and subsequent return home mark a significant milestone for Addy and Lily, as they continue to thrive and grow as a family of four, supported by their dedicated medical team and the love of their community.
