Although separating conjoined twins is a risky operation even today, the first successful separation of conjoined twins happened in 1689, by a gifted surgeon who came to a very bad end. Learn all about the first person who trained to perform this procedure, and how such a feat was accomplished in the seventeenth century.

Johannes Fatio's life served as an example of how great virtue, industry, and accomplishment won't save you from getting it in the neck. Fatio was a famous physician of his time, which was the end of the seventeenth century. It took a lot to be a great physician then, and it took even more to be a great pediatrician. Fatio was both. Not only did he make a special study of problems that afflict babies and young children, he wrote books detailing the proper ways to treat them, and simple and successful surgeries to correct them. Sadly only one of his books survives to this day, but at the time he was prolific, well-known, and well-respected.

This was why, in 1689, when a woman gave birth to conjoined twins, he was asked to do a separation. The birth of conjoined twins is a rare, but regular event. And this was not the first separation. We know, from historical sources, that a set of grown male twins was separated in Constantinople in 945 AD. One of the young men had died, and the other, knowing he had no other chance, submitted to the surgery. He only lived for three days afterwards, and no subsequent procedures fared any better.


It's not clear whether Fatio knew of this early surgery. It certainly would have been helpful, since the Constantinople twins were xiphopagus conjoined twins, just as his patients were. Xiphopagus twins are joined at a relatively small section of the abdomen, and share part of their liver. Because the liver can grow, and recover from injury, it gave these twins a very good chance for survival.

Still, any kind of surgery was a risk, and no one would have held out much hope. The twin girls, Elisabet and Catherina, were separated shortly after being baptized. The baptism was probably due to the knowledge that they might not survive the surgery. Working with a team of physicians, Fatio traced the major organs and blood vessels inside the five inch band of flesh that connected the twins, and tied a silk cord around each side before cutting the flesh between. Nine days later, the cord fell away and the twins stayed healthy and alive.

Since then there has been speculation about exactly who was with Fatio during the surgery. One person we know was certainly with him was the mayor of Basle, the town where Fatio lived and worked. This proved to be his downfall.


Years later, Basle fell into political turmoil, with two different factions warring for control of the city. Fatio sided with the faction that — briefly — won. The other group turned the tables, though, and when the city fell, Fatio was imprisoned, tortured, and killed. His many books were confiscated and burned by the authorities. Only one book was spared, The Helvetic Reasonable Midwife, and that was suppressed until seventy years after Fatio died. This is why we know relatively little of his work and his innovations. So remember kids, good deeds, fabulous intellectual accomplishment, and helping babies don't count — just you be sure you get your politics right.

Top: Library of Congress

Via NCBI, NCBI, Cambridge, The Royal College of Surgeons.