Texas Children's Hospital announces successful separation of conjoined twin brothers Lucas and Mateo


The complex 17-hour operation included experts from almost every pediatric surgical subspecialty and is one of two successful separations in less than a year at Texas Children’s

Downloadable pictures and b-roll of the twins is accessible here.

HOUSTON (July 17, 2023)Texas Children’s Hospital is pleased to announce that formerly conjoined twin brothers Lucas and Mateo Villalobos Barrera are doing well at home nearly a year after they were successfully separated on August 17, 2022. Connected at the lower abdomen and pelvis, the boys shared multiple organs, including small intestines and a single colon, a condition known as ischiopagus twins.

Lucas and Mateo’s case represents one of two successful separations in less than a year at Texas Children’s. The very complex operation, led by Dr. Alice King, a pediatric surgeon at Texas Children’s Hospital and Assistant Professor of Surgery, Division of Pediatric Surgery at Baylor College of Medicine, lasted 17 hours and included a multi-disciplinary team consisting of:

• 4 pediatric surgeons
• 2 plastic surgeons
• 2 orthopedic surgeons
• 1 neurosurgeon
• 4 anesthesiologists
• 8 registered nurses
• 5 surgical technicians

“This incredibly complex case utilized nearly every single surgical subspecialty at Texas Children's Hospital,” said King. “The size and scope of the teams involved with Mateo and Lucas’s care was vast, and there are very few hospitals that could perform a procedure this multifaceted. I could not be more proud of the team responsible for this excellent outcome, and I am excited for what the future holds for these brothers.”

“The success of this separation can be attributed to the tireless dedication and unparalleled work ethic of our team,” said Dr. Larry Hollier, Surgeon-In-Chief at Texas Children’s Hospital and Vice Chair of Surgery at Baylor College of Medicine. “Countless hours of preparation went into this incredibly intricate surgery, and we are beyond grateful with the result: two healthy, happy boys.”

Upon hearing that she was expecting twins, Lorena Barrera and her husband, Alejandro Villalobos, were surprised and excited. Already parents to three other boys named Aaron, Gerardo and Cesar, they were looking forward to adding more sons to their family. However, their happiness soon turned to concern when they learned their babies were conjoined. The family, who lived in Las Vegas, decided to relocate to Houston halfway through Lorena’s pregnancy so they could receive prenatal care from world-renowned maternal-fetal medicine experts at Texas Children’s Fetal Center.

Lorena underwent extensive prenatal imaging beginning at 24-weeks’ gestation to determine if the boys could be separated after birth, including fetal MRI and weekly ultrasounds that also informed the team planning her Cesarean section. Additionally, a labor and delivery simulation conducted at 31 weeks allowed the team to rehearse all the necessary protocols for planning the babies’ delivery.

“Every set of conjoined twins poses unique anatomical challenges that require extensive planning for a safe delivery for both mom and babies,” said Dr. Michael Belfort, Obstetrician and Gynecologist in-Chief at Texas Children’s Hospital and Chair of the Department of Obstetrics and Gynecology at Baylor College of Medicine. “Once Lorena was referred to our team, she underwent diagnostic imaging that allowed us to successfully coordinate delivery and help the immediate postnatal management of the twins. With very detailed planning and simulation training, we were prepared for this complex delivery.”

The babies were born at Texas Children's Pavilion for Women on January 18, 2022, at 10:29 a.m. and weighed a combined 8 pounds and 4 ounces. Shortly after birth, the twins transferred to Texas Children's l level IV Neonatal Intensive Care Unit (NICU), where they would spend the next seven months growing in preparation for their separation.

“We knew from their first interaction with the Fetal Center that the team needing to care for Lucas and Mateo was going to be massive, and we have all of the necessary experts in one place,” said Dr. Rita Shah, a neonatologist at Texas Children’s Hospital and Assistant Professor of Neonatology at Baylor College of Medicine. “Throughout their NICU stay, the boys had nearly 30 different teams taking care of them, including urologists, orthopedists and other surgical specialists; neonatologists, radiologists and numerous other medical specialists; nurses, occupational and physical therapists; Child Life specialists; and chaplains — all providing the expert care they needed to make it through their journey to successful separation and then going home.”

Prior to their separation, the boys underwent a procedure on June 8, 2022, to place tissue expanders, similar to balloons that allow the skin to stretch gradually, which gave the twins additional skin ahead of that operation.

Following their successful separation surgery, which included extensive orthopedic reconstruction to their hips that would allow them the chance to walk, the boys returned to the NICU for two more months.

At nine-months old, after spending their entire lives in the hospital, the boys were discharged from the NICU on October 26, 2022. The family remained in Texas for several months following their discharge, and after a final operation for each brother individually on June 28, 2023, the family has returned home to Las Vegas.

Lucas and Mateo are now starting to walk and continue to amaze their parents, who never lost hope that the day their babies took their first steps would arrive.

“I don’t know what else we can ask for in life,” Lorena said. “We have our boys here, and that is God’s gift to us. We are eternally grateful to the specialists at Texas Children’s. It is from the hand of God that my children are here. The nurses and the specialists were excellent. We are very grateful indeed. This may be a long journey, but we ask that life and God give us the strength to keep looking after them and doing all the hard work.”

About Texas Children’s Hospital

Texas Children’s, a nonprofit health care organization, is committed to creating a healthier future for children and women throughout the global community by leading in patient care, education and research. Consistently ranked as the best children’s hospital in Texas and among the top in the nation, Texas Children’s has garnered widespread recognition for its expertise and breakthroughs in pediatric and women’s health. The system includes the Texas Children’s Duncan NRI; the Feigin Tower for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, the first hospital devoted to children’s care for communities north of Houston. The organization also created Texas Children’s Health Plan, the nation’s first HMO for children; Texas Children’s Pediatrics, the largest pediatric primary care network in the country; Texas Children’s Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that s channeling care to children and women all over the world. Texas Children’s Hospital is affiliated with Baylor College of Medicine. For more information, visit www.texaschildrens.org

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