First of Jacksonville, Florida’s formerly conjoined Mirabal twins, Conner, leaves Wolfson Children’s Hospital 

Formerly conjoined twin Conner Mirabal got the go-ahead by his medical-surgical team to be transferred November 30, 2015, to Brooks Rehabilitation Hospital, where he will undergo intense inpatient rehabilitation. Born December 12, 2014, at UF Health Jacksonville and successfully separated from twin brother Carter on May 7, 2015, at Wolfson Children’s Hospital in a complex 12-hour surgery by Nemours Children’s Health System pediatric surgeons, Conner has a feeding tube and is growing and thriving. His brother Carter is scheduled to have surgery later this week to have a feeding tube placed in his belly and will continue to recover at Wolfson Children’s.

The twins’ parents, Bryan Mirabal and fiancée Michelle Brantley, hope to bring Carter home early next year. Carter may also require intense rehabilitation at Brooks as well before he will go home.

“We are so excited that we are one step closer to getting our babies home!” said Mom Michelle. “Carter and Conner are miracle babies. We are blessed to be their parents.”

The smaller of the two boys, Carter’s recovery has been a little more difficult than Conner’s as he experienced a few setbacks during recovery, including a bowel repair procedure in mid-May and weaning off of oxygen therapy. He continues to work with speech, occupational and physical therapists with Wolfson Children’s Rehabilitation to achieve the developmental milestones of a baby without medical challenges.

Both boys will receive long-term outpatient therapies with Wolfson Children’s Rehabilitation once they leave the inpatient setting of Brooks Rehabilitation. They will also require follow-up care with multiple pediatric specialists at Nemours Children’s Specialty Care, Jacksonville, including pediatric orthopedic surgery consults for both boys due to their scoliosis, an ophthalmologist for Carter for an eye condition, and others, as needed.

Conner and Carter Mirabal were born conjoined from the sternum to the lower abdomen by tissue, shared their small intestine, and had individual livers and bile ducts that were fused together. Shortly after their birth, they were transported to Wolfson Children’s Hospital, where twins had emergency surgery on Dec. 13, 2014, to repair a potentially life-threatening condition called a ruptured omphalocele, in which their shared small intestine protruded through a weak area of the abdominal wall. Daniel Robie, MD, chief of pediatric general surgery, and Nicholas Poulos, MD, pediatric general surgeon, for Nemours Children’s Specialty Care and Wolfson Children’s Hospital, positioned the babies’ shared small intestine back inside their abdominal wall and placed a temporary mesh patch over it to keep the bowel inside. The boys recovered for months in Wolfson Children’s Newborn Intensive Care Unit.

On Jan. 2, 2015, the boys underwent an additional surgery to remove the temporary mesh. Dr. Robie and Dr. Poulos then partially separated the shared small intestine to enable the babies to feed orally. During the procedure, the pediatric surgeons discovered that the boys had two bile ducts that also were fused.

On May 7, 2015, Carter and Conner underwent a final, successful separation surgery. The surgery involved a 17-member surgical care team led by Dr. Robie; Dr. Poulos; Carolyn Bannister, MD, chief of pediatric anesthesiology for Nemours Children’s Specialty Care and Wolfson Children’s Hospital; and Stephen Dunn, MD, Division Chief of Solid Organ Transplant for Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del. Dr. Dunn travelled to Jacksonville to assist the team in separating Conner and Carter’s fused livers.

UF College of Medicine – Jacksonville pediatric critical care physician Solange Benjamin-Thorpe, MD, led the team that cared for the boys immediately following their final separation surgery and until Conner was transferred to the medical/surgical floor on June 23, followed by Carter on Aug. 5. She said, “The dedicated staff of the Pediatric Intensive Care Unit is extremely pleased with how well the boys have done.”

The boys continued their recovery on the Progressive Care/Orthopedic Unit at Wolfson Children’s Hospital, where Carter is expected to stay until he can be discharged.

“Both Carter and Conner are doing remarkably well,” said Dr. Robie. “The team has grown very close to the boys and their family, but we are looking forward to the news that they are home and thriving, and living the normal lives we expect them to have.”

Conjoined twins are extremely rare, with estimates ranging from one in every 100,000 births to one in every 200,000 births. The Mirabal twins are the first known set of conjoined twins born in Jacksonville.

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