'A Ray of Hope.' Meet Ben Gbulie, M.D., FACS

Uzoma “Ben” Gbulie, M.D., FACS,  has been caring for AmieLynn Rose and JamieLynn Rae Finley before they were even born. He was one of the first doctors the twins’ parents consulted after finding out their girls were joined at the lower sternum and abdomen. 

“I’ve been looking out for these babies since they were in the womb. I spent a lot of time studying intrauterine ultrasounds and MRI images even before they were born. They’re basically like family to me,” Dr. Gbulie said.

Giving Patients a Ray of Hope
In elementary school, Dr. Gbulie realized becoming a doctor was his calling. By the time Dr. Gbulie graduated from medical school, he knew surgery would be his path. He started out in General Surgery but during his second year of training discovered that he wanted to repair instead of remove.

“I have been privileged to train and become a board-certified General Surgeon, board-certified Plastic Surgeon as well as a Pediatric and Craniofacial Plastic Surgeon. Plastic surgery is very rewarding to me because it allows me to fix things and replace whatever was removed so it gives my patients a ray of hope. Filling that void in someone else’s life brings me great fulfillment.”

Finding the Right Facility for the Twins 
This is Dr. Gbulie’s astonishing third time managing a set of conjoined twins. He had already been involved in two prior separation surgeries – one in 2011 where the male twins were joined at the sacrum, and the other in 2016, where the female twins were joined at the hips/pelvis.

“A separation surgery is as complex as it gets. It’s rare to do even one of these cases in one’s career, and a privilege to be invited to take care of a third set of conjoined twins.”  

When the twins’ mom Amanda Arciniega was only three months pregnant, she reached out to Dr. Gbulie after her mother-in-law’s best friend mentioned she knew a surgeon who had experience with conjoined twins. Amanda and her husband, James Finley, met with him at his office. 

“We had a long talk about where and how it would be best to deliver the babies and eventually separate them. They wanted the assurance that if they stayed in the area, we had a facility where they could be separated. Being a member of the Surgery department at Cook Children’s Medical Center, I was very glad to assure them that Cook Children’s definitely has that capability.”

Expect the best and prepare for the worst 
Dr. Gbulie said it is humbling when you take care of small babies who can’t make decisions for themselves. In the world of pediatrics, it’s really a doctor, parent and patient relationship. 

“As the days became closer to the actual separation, the mother became more emotional. The family has trusted not only me, nor the entire team but also Cook Children’s Medical Center to take care of their precious babies.” 

By reviewing the surgical anatomy, imaging and operative plan enough times that it became second nature, Dr. Gbulie felt that they had reduced the chances of unanticipated surprises. He also planned the original incisions since the way they open affects the way they close. The main challenge for his part would be the complexity of the closure.

The closure could be a complex repair or possibly require a graft or tissue substitute.

“That portion would be a game time decision depending on what we find and how the babies are doing.”

Once the separation is done and closure completed, the twins will be handed over to the Neonatal ICU team. 

“Of everything I have learned from other separations, one of the most important lessons is the importance of the perioperative care. The preparation of the twins by the neonatal unit, making sure they were gaining weight, their electrolytes were normal, their respirations optimal and so forth – all of those allow them to tolerate a very long operation, followed by the hugely important post-operative care. It really does take a village.”

Dr. Gbulie’s motto for surgeries such as this one is to expect the best and plan for the worst. 

“And with God, it will go great.”

Indescribable Joy 
On January 23, the day of separation, Dr. Gbulie remained focused. “Knowing it is my responsibility to take care of another human being, especially when it is a child, is a huge motivator and keeps me focused no matter how long the surgery takes.”

He made the original incisions to be sure the skin flaps were protected for good closure. 

“Once we got into the nitty gritty parts of separating the liver and bowel, I took a step back.”

For the next 2.5 hours, Dr. Gbulie took on the role of assisting the pediatric surgeons as the separation of the organs proceeded. Time seemed to stand still as he watched all the hours of meticulous planning by the team fall into place.

Following separation, the pediatric surgery team worked on the diaphragmatic and abdominal fascial repair using mesh. Then it was time for Dr. Gbulie to close JamieLynn which he performed using skin advancement flaps. When it was all done, he stated: “To be able to do give this (gift of separation) to the family is an indescribable joy.”

Cautious optimism 
Dr. Gbulie said high fives won’t really come until weeks from now. The separation is a major step but is the first part before the recovery truly starts. He will breathe a sigh of relief when the twins go from surviving to thriving.

“The skin is the largest organ in the body and protects our interactions with the environment. It’s really important to get them well healed and a stable wound because without that, more problems could arise such as post-operative infections.”

He feels fortunate for not only the twins’ medical team but Cook Children’s as a whole. 

“There are not many medical centers in the world that have done this procedure. I think this proves that we have a hospital system that literally has every subspecialty and the technology required to pull off something this complex. That’s an amazing achievement and I’m very grateful for that.”

When asked about his work, he stated “I love every bit of what I do, and if given the choice I would always choose to be a plastic surgeon. My training and experience have given me the opportunity to help another set of conjoined twins and I consider that a blessing.”

Background
Dr. Gbulie is a member of the Plastic Surgery Department at Cook Children’s Medical Center. Besides his elective practice, he also provides on-call coverage for facial and hand trauma and has handled many complicated cases including severe dog bite injuries to the face and scalp which require literally putting the child's face back together.

“It's amazing how fulfilling it is to make the child whole and see them smile again, especially when we're able to achieve this with minimal scarring and deformity.”

“The Essential Glue”

“My wife Ndidi is an attorney, the love of my life and the essential glue that holds our family together. We're blessed with three wonderful kids – Amaka (14), Sam (11) and Obi (9). During my free time, I love watching soccer and I’m quite sure I’m the biggest Manchester United fan!”