Pediatric surgeon Steven Stylianos is with Carmen (right) and Rosa Taveras

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Pediatric surgeon Steven Stylianos is with Carmen (right) and Rosa Taveras, who is the mother of Elijah, whom Stylianos helped to bring into the world recently. More than 20 years ago, when the women were babies and conjoined twins, Stylianos oversaw the complex surgical procedure to separate them, allowing them to lead normal lives.

Photography: 
Charles E. Manley

For pediatric surgeon Steven Stylianos, separating conjoined twins Carmen and Rosa Taveras was the opportunity of a lifetime, a fortuitous confluence of being in the right place—Babies Hospital at Columbia-Presbyterian Medical Center in Manhattan—at the right time—1993. The Healing the Children Midlantic foundation had taken on the cause of the baby girls from the Dominican Republic, who were joined pelvis to pelvis. But Stylianos RC’78, in the early years of a promising career, had earned his wings before taking on the challenge.

Conjoined twins account for one per 200,000 live births. Of those who live, most are fragile and survive only a few days, and others share a major organ such as the heart or are joined at the head, making separation deadly. Approx­imately 225 successful separation surgeries have been performed—with success defined as the survival of just one twin.

The odds did not deter Stylianos. As a Rutgers biology major and then a student at New York University (NYU) School of Medicine, he was headed for a career in obstetrics-gynecology—that is, until an NYU Medical Center surgeon and preceptor, noting his talent in the operating room, steered him into surgery. After a residency at Columbia and two fellowships in pediatric surgery and pediatric trauma surgery in Boston (nine years of training), he returned to Columbia-Presbyterian. Along the way, he had honed his operating room skills and had witnessed the separation of several pairs of conjoined twins by a top surgeon in the field.

When the chair of the pediatric surgery department at Columbia-Presbyterian was approached to take on the separation of Carmen and Rosa, he agreed—but only if Stylianos would lead the planning and head up the surgical team. The young surgeon accepted the task immediately, determined that the twins under his care would survive and thrive.

Flush with the rush of excitement, he dove headlong into researching and sketching how the girls’ shared parts could be repositioned, and he assembled the operating room team. His lifelong passion had always been to make children’s lives better; now Stylianos saw the possibility of making history. “Siamese twins have always fascinated the world,” he says.

Fifty-two people participated in the surgery, which took an epic 18 hours to complete, conducted in two side-by-side operating rooms. With Stylianos as both maestro and primary surgeon, the day went as planned. The surgery entailed not only separating and correctly repositioning the girls’ reproductive organs, urinary tracts, and bowels, but also reconstructing their hips and pelvis.

Several days later (after a “speedy and uneventful recovery”), when the girls were released from the hospital and secured in two car seats for the first time in their lives, the team was overcome by a sense of pride and accomplishment, one that lasted for years. 

Twenty years later, in November 2013, Rosa returned to Columbia-Presbyterian, now New York-Presbyterian/Columbia University Medical Center, this time to deliver a healthy baby boy, Elijah—becoming only the fourth known conjoined twin in history to give birth after surgical separation. Stylianos was present in the delivery room, holding Rosa’s hand as she underwent a cesarean section procedure and making sure that the obstetricians encountered no surprises with Rosa’s anatomy. For Stylianos, and other team members who were still associated with the hospital, the event was awe-inspiring. “I’ve been so fortunate,” says Stylianos. “I was so well prepared by my teachers and mentors, and then this golden opportunity came along.”

As a pediatric trauma surgeon, Stylianos knows he has changed the lives of many children. But it’s Carmen and Rosa, and now Elijah, who have clearly changed his.