2A 06-06 Amy Jesse Carlsen twins.jpg

Dr. Christopher Moir, the lead surgeon for the Mayo Clinic team that performed the separation surgery on the conjoined twins, visits with Amy Carlsen holding Isabella and Jesse Carlsen holding Abbigail, at a farewell party for the twins prior to the family heading home to Fargo, N.D. in June , 2006 Several hundred staff members and well-wishers attended the event in a Saint Marys courtyard.

Editor's note: Each day this week, the Post-Bulletin is taking a look back at key factors in Mayo Clinic's 150 years of development. Mayo is celebrating its sesquicentennial with an exhibit called "Mayo Clinic: 150 Years of Serving Humanity." It's open until 7 p.m. today and until 4 p.m. Saturday, it's final day in Rochester). Today, we look back at a the unprecedented surgeries in 2006 to separate conjoined twins.

Two 8-year olds became famous by happenstance of birth.

Isabelle and Abbigail Carlsen, of North Dakota, were born connected at the abdomen.

In 2006, a phone rang at Mayo Clinic and a medical secretary struggled to answer the questions of distressed parents Jesse and Amy Carlsen, who wanted to find the best medical team to surgically separate their newborn girls.

"It's a dad," the secretary told nurse practitioner Penny Stalvo. "He wants to talk about his kids that were born with … I don't know exactly what he's saying,".

That phone call led to a whirlwind of media attention, worry and prayer, culminating in an unprecedented surgery on Mother's Day.

About five minutes after Stavlo had talked with Jesse Carlsen, the phone rang again.

It was Mayo Clinic public affairs.

Word had spread like wildfire that the Carlsens planned to travel to Mayo Clinic, and major news programs were already calling.

Abby and Belle, as they were affectionately known during their lengthy stay at Mayo Eugenio Litta Children's Hospital in Rochester, had a single liver, a shared bile duct, a shared bowel and overlapping hearts that all needed separation or reconstructive surgery.

As Mayo specialists asked for consults about the complex and unique case, specialist after specialist was added to the team. About 70 staff members played a significant role in the girls' care.

They came from occupational therapy, physical therapy, chaplain services, cardiac surgery, radiology, infectious diseases, social work, security, cardiac ICU nursing and a variety of other departments.

The medical team held weekly joint meetings for the month leading up to the monumental surgery.

All the while, nurses cared for the girls during their 75-day stay. Health providers spent weeks placing stretching balloons under the girls' skin so each girl would have enough skin to properly close their wounds after surgery.

Lead surgeon Dr. Christopher Moir expressed the feeling of medical staff in general when he told the Post-Bulletin that the girls "really touched all of us here at Mayo, touched all of our hearts."

Machinery got color-coded with electrical tape so it was clear which girl the equipment belonged to.

Dr. Randall Flick hugged Amy Carlsen when she and her husband turned the girls over to the medical team. The harrowing surgery included a "millimeter by millimeter" separation of internal organs. But health providers were prepared with anatomical mapping, thousands of 3-D images and even spongy hand-held, life-sized models representing the girls' own internal organs.

The Carlsens were told there was only a 60 percent chance that both girls would survive the separation. But complex and detailed anatomical mapping improved their chances to at least 90 percent.

At 4:28 p.m., after about eight hours of surgery, "spontaneous applause came when they were separated," Stavlo said.

Afterward, an emotionally and physically exhausted Flick literally slid down the wall to the floor.

The girls were slowly weaned from their ventilators.

"It took a team," Stavlo said.

Prayer sustained the family throughout.

"Thank you, Lord, for answering our prayers!!!" the Carlsens wrote on their CaringBridge site after the surgery. "Abby and Belle are now two separate girls and just as beautiful as always!"

Two more successful separation surgeries happened at Mayo Clinic that same year. Abygail and Madysen Fitterer were separated in October. Jacob and Jordan James were separated in November.

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