Jesse Carlsen, Amy Carlsen, Abby Carlsen, Belle Carlsen
Ann Heisenfelt  /  AP file
Jesse Carlsen, left, and Amy Carlsen, right, talk to their daughter Abby, bottom, while her sister Belle sleeps at St. Mary's Hospital in Rochester, Minn.
updated 5/13/2006 8:22:33 AM ET 2006-05-13T12:22:33

For the parents of conjoined twins Abbigail and Isabelle Carlsen, placing their baby daughters on an operating table was one of the hardest moments.

But the daylong surgery worked. Doctors untangled their livers, repositioned their hearts and divided a shared intestine. The girls, who spent their first five months with their noses just inches apart, finally slept in separate beds Friday.

“It was beautiful. They looked great. It was just amazing. They looked wonderful,” said their mother, Amy Carlsen.

“If any of you looked outside today, you noticed it was cloudy and rainy and the sun was nowhere to be seen,” said their father, Jesse Carlsen. “I think that’s because it was in that operating room, with our girls and this team.”

The girls, separated by a team of Mayo Clinic surgeons, have a tough recovery ahead.

“They are critically ill and we expect them to stay that way for the next 24 to 48 hours,” said Dr. Christopher Moir, the lead surgeon. He said the girls then can hopefully come off a ventilator and perhaps begin waking up.

When the girls were born Nov. 29 to the Fargo, N.D., couple, they were joined at the diaphragm, pancreas and liver, and shared a common bile duct and part of an intestine.

Major multiple surgeries
A 70-member Mayo Clinic team has cared for the twins since Feb. 24. About 30 people took part in the operation, with specialists rotating in and out of the operating room. The separation, which took nearly seven hours, was like one major surgery after another.

On Friday morning, Amy and Jesse Carlsen helped take their daughters to the operating room.

After the procedure began, doctors confirmed the girls had two separate hearts. Medical imaging done in the weeks before the surgery showed Isabelle’s heart was tipped into her sister’s body and would have to be moved.

Mayo spokesman Lee Aase said Isabelle’s blood pressure remained stable as her heart was maneuvered into her own chest cavity.

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Doctors also removed both of the girls’ gall bladders during the procedure, so the drainage systems in the organs could be rerouted, Aase said.

He said that after the girls’ livers were separated, the medical team applauded, having completed one of the more complicated parts of the operation because of the way the organs were fused and because the circulatory structures inside the livers needed to be divided correctly.

Isabelle retained the common bile duct, and doctors constructed a biliary structure for Abbigail. The length of their intestines was a concern, too, but doctors found enough and divided it evenly between the girls.

Doctors had estimated there was a 90 percent to 95 percent chance that both girls would survive.

“The girls did great,” said Dr. Randall Flick, the lead anesthesiologist. “The credit goes to them. I think they are tough little girls.”

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