Oh

I'm more suprised that they didn't know like, who in the whole kingdom can do procedure on a royal. Or even DO the procedure. Obviously it's our girl Elise/Rose

When entering the hospital, Elise use a fake name 'Rose' introduced as a viscount daughter, of course They wouldn't expect 'Elise', the marquess daughter would actually be the same person.

I remember now I was like, who else could've done the procedure??
It makes sense that they didn't know. Just read ch 38 & it does talk about her faking identities in that chapter.