Today marks one year since cheers rang out and tears of joy streamed in a private family waiting area at Cook Children’s Medical Center - Fort Worth following a long-awaited and monumental announcement to the parents and family of conjoined twins JamieLynn and AmieLynn Finley.

“You have two babies on two separate beds.” 

The declaration that the sisters were successfully separated in an 11-hour surgery performed by a team of 25 medical professionals, including six surgeons, was more than a year in the making. Planning and preparation for the twins’ complex care and intricate surgery began months before the girls were born. Back then, all hoped and prayed for the best, but few could imagine that seven short months after their separation JamieLynn would take her first steps, followed by sister AmieLynn a month later. Today, they’re moving at a toddler’s pace, keeping mom and dad on their toes and on high alert.

A Look Back

The sisters’ story began like many others. Parents James Finley and Amanda Arciniega wanted to add one more baby to their family of five. Little did they know, or expect, their hope of one more would become a gift of two.

Shortly after learning of the pregnancy, Finely and Arciniega were presented with the news of a serious complication. Their twins were joined at the abdomen and shared a liver. The revelation set into motion a series of events that led the family to Cook Children’s Medical Center, where a team of physicians and medical professionals across multiple specialties collaborated for months to care for the girls and plan and practice the complex surgery to separate them. 

On January 23, 2023, JamieLynn and AmieLynn became the first set of conjoined twins to be separated at Cook Children’s. The day was proclaimed JamieLynn and AmieLynn Day by the Tarrant County Commissioner’s Court in April 2023, shortly after the girls were released from the hospital.

A Full and Exciting Year 

It’s been a year full of life’s first for the girls, with every milestone made magical considering how they’re journey began.  In October, JamieLynn and AmieLynn celebrated their first birthday. They’re learning to talk, too. “Momma,” “dada” and “Bubbles,” the name of the family dog, are among their first words in an ever-growing vocabulary. Strike up a game of paddy cake, and they giggle, wiggle and jive. Their dad says it’s their favorite thing to play together or with others.

A History-Making Team

The sisters’ separation made headlines around the world with stories appearing on local and national news outlets, including the Today Show, CBS News, Good Morning America and People magazine, to name a few. In December, the Texas Hospital Association (THA) highlighted the twins’ health care team, affectionately dubbed Team JamieLynn and AmieLynn, for THA’s 12 Days of Health Care Heroes recognition.

Jose Iglesias, M.D., medical director of Pediatric Surgery at Cook Children’s, was the lead surgeon on the case. In an interview shortly before surgery day, Dr. Iglesias talked about the privilege of being trusted with the historic surgery.

“It is always an honor and one that I do not take lightly when a parent entrusts me with their most prized possession. The opportunity to separate conjoined twins is an exceptional privilege most pediatric surgeons never get. It is only because we are standing on the shoulders of giants who have trained us, and incredible leaders who have laid the groundwork for this extraordinary institution that we are able to fulfill our Promise. In 105 years, Cook Children’s has never been presented with the opportunity to care for conjoined twins. This will forever be a part of our history, and it is a great honor to all of us that Amanda and James have entrusted us to provide care to AmieLynn and JamieLynn.”

Happy Separation Day to JamieLynn and AmieLynn! Everyone at Cook Children’s is so proud to be a part of your story. And to Amanda and James, happy toddler chasing! May every step be a magical reminder of how far your strong and resilient daughters have come.

On Jan. 23, 2023, JamieLynn and AmieLynn made history as the first conjoined twins to be surgically separated at Cook Children’s. The girls were conjoined at the chest and shared a liver. Their 11-hour surgery involving a team of 25 medical professionals, including six surgeons, made headlines around the world. The girls were being cared for at Cook Children’s Neonatal Intensive Care Unit (NICU) since birth. Last week, AmieLynn was discharged and both girls are living with their family in Fort Worth.

Their parents, James and Amanda, attended the meeting Tuesday, all smiles as they held Jamie and Amie in their arms.

The proclamations read:

Proclamation - JamieLynn and AmieLynn Finley Day

Whereas, when parents James Finley and Amanda Arciniega of Saginaw found out they were expecting twins, they were surprised; then a short time later that surprise turned into worry when they learned their babies were conjoined; and

Whereas, while Mother-to-Be, Amanda, enjoyed an easy and uncomplicated pregnancy, there were many hours spent meeting with specialists from across the state to determine who was best to deliver the Finley Twins and the best hospital to care for them after birth; both of which ended up being right up the road and

Whereas, on October 3, 2022, at 34 weeks gestation JamieLynn and AmieLynn were delivered via C-section at Texas Health Fort Worth. After a monthlong stay at the Texas Health NICU, the girls were transferred to Cook Children’s Medical Center NICU; and 

Whereas, after months of planning and collaboration, which included building the medical team, troubleshooting potential issues and rehearsing the carefully choreographed surgical production; the medical team determined when the girls reached 4 months old, it was right time to separate them; and

Whereas, on January 23, 2023, after an 11-hour surgery, with a team of 25 medical professionals, including 6 surgeons, Cook Children’s Medical Center successfully performed its first-ever separation surgery on 16-week-old conjoined twins, JamieLynn and AmieLynn.

Now, therefore, be it resolved, that we, the Commissioners Court of Tarrant County, do hereby proclaim January 23, 2023, as JamieLynn and AmieLynn Finley Day in honor of their successful separation surgery. 

In witness whereof, we have hereunto set our hands and caused the Seal of Tarrant County to be affixed this 18th day of April 2023.

Congratulatory Resolution - Cook Children's Medical Center

Whereas, located in the heart of Fort Worth’s Medical District, Texas Health Harris Methodist Hospital and Cook Children’s Medical Center share a long history of collaboration; and 

Whereas, both organizations have a close working relationship bonded through the common goal of putting family first while providing advanced medical treatments with heartfelt compassion to families in need throughout Tarrant County and across the State of Texas; and 

Whereas, the nationally recognized neonatologists, pediatricians, specialists, researchers, and clinicians of Cook Children’s Medical Center’s NICU are specially trained in the complexities of critically ill newborns and babies born prematurely; and 

Whereas, the Doctors, Nurses & Staff inside of Cook Children’s Medical Center & the Level IV NICU tirelessly work around the clock, every single day of the year to provide critical care for the most difficult and complex medical diagnosis, including the tiniest, micro preemies born as early as 23 weeks and weighing as little as one pound; and 

Whereas, on Monday, 23rd of January, a remarkable team of 25 medical professionals and 6 surgeons performed a groundbreaking 11-hour surgery to separate conjoined twin sisters, AmieLynn Rose Finley and JamieLynn Rae Finley of Fort Worth, Texas. 

Whereas, the incredible team assembled by Cook Children’s Medical Center and their collective expertise in treating the most difficult, rare and complex pediatric conditions, made this challenging procedure successful and the Finley family whole again; and 

Whereas, the citizens of Tarrant County recognize the critical need for the Neonatology Team at Cook’s Children’s Medical Center who are committed to the care and well-being of North Texas families; and 

Now therefore, be it resolved, that we, the Commissioners Court of Tarrant County, do hereby honor and congratulate the teams of nursing & medical professionals at Cook Children’s Medical Center and the NICU on their continued efforts in our community. In witness whereof, we have hereunder set our hands and caused the Seal of Tarrant County to be affixed this 18th day of April, 2023.

By Jean Yaeger

Marty Knott, D.O., Ph.D. was AmieLynn’s primary surgeon during the historic procedure to separate conjoined twins, AmieLynn and JamieLynn, on Jan. 23, 2023. Although this was his first time separating conjoined twins, Dr. Knott brought experience in operating on chest wall deformities, congenital malformations of the abdomen and chest, abdominal wall defects, tumors, bowels and vascular anomalies. He has worked at Cook Children’s for seven years.

Here are excerpts from a conversation with Dr. Knott prior to the twins’ separation.

It sounds like the area where these girls are joined is where you work quite a bit. Exactly. That's the interesting thing about it.  The actual surgery parts, if you break them down, are things that we do very commonly -- liver surgery and closing abdominal defects in newborn babies. So a lot of the techniques, skills and experience from other places can all be combined into this unique situation. The actual procedures themselves are pretty common.

How did you prepare specifically for this surgery? We have been meeting within our group but also with other subspecialties such as anesthesia and plastic surgery, as well as all of the different components of the operating room team, such as the certified scrub techs, OR nurses and anesthesia techs. It's one of those things where you have a huge team that comes together and everybody plays their role individually to make things happen. And then there's individual preparation by reviewing the scans and charts and the things that they've gone through so far, to just know what things might come up on that day.

Potentially what’s the biggest challenge? The liver separation part's going to be tedious. But the biggest issue is probably going to be getting their abdominal cavities closed and covered safely, because they do have a shared area from their lower sternum down to their belly button area that is open, meaning there's some separation of the muscle and the skin. Just finding effective ways to get that closed once the division has occurred is probably the most hard-to-predict part. For me that feels like the biggest unknown challenge. Everything else is relatively straightforward.

There are different techniques we use. We have babies that are born with other abdominal wall defects that aren't conjoined who still need some sort of either permanent or temporary closure. We'll use some of those techniques we use in other situations for them too. We’re just trying to figure out what's best and preparing for a variety of different options so that once we actually get them separated, we'll be able to know how best to close those abdominal wall defects or those openings so that the intestines, the liver and the heart are all covered safely.

While they're still conjoined, how does everyone who needs to be there fit around the table? There are a lot of people involved, and the table's not very big. To start with, it'll be Dr. Iglesias and I, and then we have two scrub techs that'll be scrubbed into the operation at the beginning. Our plastic surgeons are there as well. It'll be Dr. Iglesias and I until the babies are separated and then we form into two big full teams after that, one for Amie including Drs. Hamner and Hubli, one for Jamie including Drs. Lodwick and Gbulie.  That will be another set of at least four people around the table for each of us.

Someone steps up, someone steps back? Mostly like that, kind of scooting over and leaning. Most of the time we'll stay on our set sides. Typically, Dr. Iglesias will be on the right side and I will be on the left. We'll just work around that and figure out where everybody fits best.

Normally you operate on only one patient at a time and you can position that patient as needed. Can you speak a little bit about the fact that you may not be able to roll Amie the way you want her, because Jamie's there? They've lived most of the time on the sides where, if you're looking from their feet, Amie will be on the left and Jamie will be on the right. That's their baseline or most common position. So that's where we're going to have them during the surgery because that fits best for what they've tolerated so far. There are definitely some limitations. I always say this: In surgery, we try to use other experiences and techniques to fit into unusual situations. There are a lot of different surgeries where positioning has to change throughout the operation for us to be able to get it completed.

We're having to make some modifications within the surgery to where we can move them around a little and use different angles to get portions of the procedure completed safely. We'll use all of our experience and ideas from other situations that are more common to make that happen. But there are definitely some limitations in being able to do things as freely as we want to. Most of what we need to do while they're still joined will be pretty easy to do from the position that is most natural for them.

How long do you think it might take? Longer than expected, just with logistics of everything. Even though we've practiced multiple times, it'll be different on the real day. What I always tell parents when they ask: It'll take as long as it's necessary to get the thing completed safely. I have a timeline in my mind of how things are going to go, but I don't want to put it out there because it doesn't really matter. It's going to take as long as necessary to get them separated and keep them safe the whole time. We're planning for on an all-day event by the time everything's done.

What would you say to your colleagues at Cook Children’s?  This is one of those cool examples where everybody in the hospital gets to come together and participate. A lot of what we do gets kind of divided into little chunks where there's not much interaction between us. This has required a lot of coordination from NICU, to the nurses who know them well, the respiratory therapists, the anesthesiologists, the surgeons, the plastic surgeons and all our staff. Everybody's getting to play a pretty important role, and I hope that everybody sees the importance of what they do on a day-to-day basis.

Anything else? We're all looking forward to it and just asking for prayers that everything goes perfectly and that they recover well.