A startling video shows a “marathon” 24-hour operation to separate conjoined twins born fused at the skull.
Abigail and Micaela Bachinskiy were just nine months old when they underwent the painstaking procedure that required more than 30 doctors to perform.
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Connected at the head since birth, the girls were completely separated during a 24-hour surgery on October 24, 2020 and were able to look at each other for the first time.
The care team spent countless hours planning the logistics of the “marathon” procedure, mapping nerves and blood vessels, practicing with joined-up mannequin dolls, and rehearsing in the custom-built operating room for the procedure.
Thirty surgeons, nurses, anesthetists and other key surgical professionals packed the operating room to help separate Abigail and Micaela, while their parents waited anxiously outside.
“This is the best gift of my life, it’s very moving, it’s a great blessing,” said mother Liliya Miroshnik.
Liliya learned she was pregnant with conjoined twins when she was 11 weeks old.
Initially informed that she would have to terminate the pregnancy, her doctor referred her to the UC Davis Fetal Care and Treatment Centerwho took care of Liliya and the twins from that point on.
Abigail and Micaela were born in December 2019 and spent seven weeks in the neonatal intensive care unit (NICU) before returning home.
They were born connected at the head, a condition called craniopagus twins.
While conjoined twins are already extremely rare, craniopagus twins are even more so – with only 2% of conjoined twins born fused at the head.
Craniopagus twins occur in approximately one in every 2.5 million births, according to University of California at Davis.
METICULOUS PLANNING
Surgeons decided to separate the conjoined twins when they were nine months old, as the procedure would become riskier the longer they waited.
Leading plastic surgeon Granger Wong explained: “As they age, there is more risk of shared blood vessels and organs becoming larger or more intertwined.”
To prepare for surgery, the team spent months carefully tracking the twins’ growth through MRIs and CT scans.
In the months leading up to the procedure, Dr. Wong’s team placed custom tissue expanders under the skin of the girls’ heads to encourage the growth of more skin and ensure there would be enough to cover the exposed heads after the separation.
They also made several models of the twins’ 3D-printed fused skulls and used mixed reality glasses to familiarize themselves with the complex network of blood vessels they needed to untangle and separate.
UC Davis documented the surgery preparations and marathon procedure in a six-part video series.
‘A CHOREOGRAPHED BALLET’
Rehearsals became reality for the UC Davis surgical team when they filled the custom operating room on October 24, 2020.
With a photo of the twins, their parents Liliya and Anatoliy and their three older brothers looking after them, the doctors donned different colored caps to delineate their roles on the day.
The lead surgeons wore black caps, those caring for Micaela wore purple caps while those caring for Abigail wore orange.
The surgical residents wore gray caps and could help any of the girls.
Even the equipment was labeled with purple and orange tape so teams knew what to grab.
“Everyone knew where they needed to go and it went smoothly,” said clinical nurse Aida Benitez.
Despite careful planning, there were still elements the team was unsure of about the surgery.
UC Davis Director of Pediatric Anesthesiology Dr. Raj Dhamrait said surgeons knew the twins were “connected in some way.”
“But we didn’t really understand how one would affect the other,” they added.
Other Notable Siamese Twin Stories
AN incredible example of conjoined twins was George and Lori Schappell, who defied expectations by living to age 62.
Doctors predicted that the twins, who had fused heads, would not live past their 30s.
Born on Sept. 18, 1961, in Pennsylvania, they had partially fused skulls and shared vital blood vessels as well as 30 percent of their brain, Guinness World Records reported.
Despite being united, the two lived as independently as possible.
George accompanied Lori as she worked in a hospital laundry room.
Throughout the nineties, George had a successful music career in the United States and won the LA Music Award for Best New Country Artist.
Lori and George passed away on April 7, 2024, at the Hospital of the University of Pennsylvania.
They surpassed the record held by Masha and Dasha Krivoshlyapova, who died aged 53 in 2003.
What does it mean to be a Siamese twin?
Siamese twins are twins who are born with their bodies physically connected.
They develop after an early embryo only partially separates to create two individual fetuses.
Your condition is usually discovered early in pregnancy with a prenatal ultrasound.
Siamese twins occur once every 50,000 to 60,000 births, according to the Children’s Hospital of Philadelphia.
About 70% of Siamese twins are female and most are stillborn.
Most are connected in the chest and abdomen – but others may be connected in the head, hips, pelvis, legs or genitalia.
Siamese twins often share one or more internal organs, which affects survival rates and the success of separation surgery.
Twins with separate sets of organs are more likely to survive than those who share them.
The twins had to be turned five times during the surgery, a precarious movement that required several pairs of hands.
Four hours later, Dr. Wong removed the tissue expander from the girls’ skulls.
The neurosurgery team then intervened to divide the twins’ brains and veins so they could have independent circulatory systems.
The team performed a challenging fistula ligation, a process that involved clipping and separating large shared veins.
Liliya stayed away the entire time, hoping and praying for good news with the support of family and friends, while Anatoliy stayed home with the boys.
The twins underwent a blood transfusion and, after 20 hours of procedure, their skulls were separated.
Almost exactly 24 hours after entering the operating room in one bed, Abigail and Micaela were transported in two.
Liliya was speechless at the news that her two daughters had been separated and survived surgery.
Aida remembered how “the sun was starting to shine over the buildings” as they wheeled the girls out of the operating room.
“To me, they looked like angels. The sun hit their foreheads and I realized that this is the transfer, our work here is done.”
MISSED MILESTONES
Liliya was finally able to catch each of her daughters separately.
“I wanted to hug and kiss all the doctors, all the nurses,” said the mother.
She was overwhelmed with “relief, happiness, love, appreciation” from every member involved in the painstaking process.
At 10 months old, the twins were finally able to complete steps they had missed until then – such as sitting and crawling.
And they managed to make eye contact for the first time.
Abigail and Miceala still needed a series of procedures, but they are linked for life, despite no longer being physically connected.
On a recent post on InstagramLiliya shared that the “love between [them] It is very special”.
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This story originally appeared on The-sun.com read the full story
