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Conjoined twins at the head separated, both out of surgery

Twin boys Anias and Jadon McDonald – born joined at the head 13 months ago – began a new life apart on Friday after 27 hours of surgery.

The operation began Thursday morning at the Children’s Hospital at Montefiore Medical Center in the Bronx and ended on Friday. The separation procedure itself lasted 16 hours, followed by more hours of surgery to rebuild their skulls and make them whole.
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Jadon was the first of the boys to be finished. He was wheeled out of the operating room around 7:40 a.m. on a stretcher, his perfectly shaped head wrapped in white gauze.
He was taken on an elevator to the pediatric intensive care unit on the 10th floor, where he was reunited with his parents, Nicole and Christian McDonald.
Around at 1 pm, more than five hours later, surgeons finished operating on Anias, and he was taken to the 10th floor unit — where the family was finally reunited.
This typical surgery was led by Dr. James Goodrich, considered the leading expert on what’s known as craniopagus surgery.
It marked the 7th and longest separation surgery performed by Goodrich and just the 59th craniopagus separation surgery in the world since 1952.
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The studies show that 80% of twins joined at the head die of medical complications by age 2 if not separated.
The McDonalds and Montefiore hospital invited CNN to document this remarkable and rare journey of Jadon and Anias, allowing CNN exclusive access into the operating room throughout the procedure.
Thursday was a day of high stakes and high emotion, of anxious parents and calm medical professionals. It was a day of uncharted territory and amazing, one-of-a-kind surgical activity.
Beautiful boys with deep brown eyes and a shared swirl of hair at the top of their foreheads. They came into the world together, and became two individual boys overnight.
It’s been 12 years since he last separated twins conjoined at the head at Montefiore. That was his first ever craniopagus surgery, and he’s learned much since then, performing five other separation surgeries around the world, including Syrian twins in Saudi Arabia earlier this year.
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 In the three previous surgeries, the surgical team added tissue expanders to stretch the skin to make sure there was enough to cover their new skulls. Surgeons also separated some of the veins to make way for today’s final separation.
Mom and Dad eat breakfast with their extended family and take Aza to a nearby park. Nicole is relieved to have Aza to look after because chasing after him keeps her anxiety in check.
Christian goes to a dollar store and buys packs of thank you cards. He and Nicole spend more than an hour writing personal notes to their closest friends and family for helping them get this far.
By noon, the surgical team has taken out one tissue expander and removed some temporary plates that were inserted in the earlier surgeries to hold bone back.
Nicole and Christian bide their time with family. Aza bounces off the walls. Grandparents and others pitch in to keep the 3-year-old from driving their mom and dad too crazy.
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The family members wear white T-shirts Nicole designed. The front of the shirt says Anias with its Hebrew meaning, “God has answered,” and Jadon, “God has heard.” An infinity sign — often used as a symbol for conjoined twins — goes across the middle.
Nicole made the shirts to try to raise a few bucks. Soon, she had 200 orders. The family ended up selling 1,000.
It’s a badge of honor as to who gets the last cut when separating conjoined twins.
“The last stitch,” Tepper says. “Who wants it?”
The only woman surgeon at the table, Dr. Carrie Stern, makes the historic last cut, at 2:11 a.m.
“We are official,” Goodrich says.
The room bursts into spontaneous applause.
After nearly 16½ hours, the boys are separated.

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