Nine-Month-Old Twins Conjoined At Head Are Successfully Separated In Surgery — 'A Very, Very Rare Anomaly'

Nov 04, 2020

When North Highlands, California resident Liliya Miroshnik, mother of formerly conjoined twins Abigail and Micaela, discovered that there was an opportunity to have her children separated through surgery, she was very skeptical. But in the end, her 9-month old girls did end up undergoing the 24-hour surgery on October 23 and 24 2020 at UC Davis Children's Hospital that had plenty of risks involved. Fortunately, it was successful. 

After a long surgery, the staff at UC Davis Children's Hospital were relieved to give Liliya the great news of a successful surgery. It was a "landmark surgery," as pediatric neurosurgeon Michael Edwards called it in a press release from the hospital. The hospital's success in performing this one may lead to what they hope, plenty of others in the future.

Twins Abigail and Micaela were born connected at the head. This condition, otherwise known as craniopagus twins, is an extremely rare defect occurring when one of the parents has the gene within their genotype.

“It's a very, very rare anomaly,” Edwards explained.

While the parents themselves may not have been born this way, their children hold great potential for receiving the gene and developing the condition themselves. Thankfully, the twins are now separated and on their way to living separate, but glorious lives because of a miracle surgery.

The lead pediatric neurosurgeon of UC Davis Children's Hospital claims that the girls have been doing well since their surgery and are undergoing recovery. The team at the Pediatric Intensive Care Unit has been doing its best to support the twins on their road to fast recovery.

Liliya is thankful for the wonderful team at the hospital.

“Everything went well. It felt almost impossible to separate them, but God and the doctors and nurses at UC Davis made it possible. We are so thankful,” Liliya said in a press release.

She first learned that her twins were conjoined when she was 11 weeks into her pregnancy. She had already birthed three boys and was shocked to learn the news about her twins. Her husband was very supportive during her pregnancy and talked her through it, hoping to calm her fears and anxieties.

Liliya was referred to the hospital by her previous gynecologist who thought that the hospital was better equipped to handle her situation. She spent the majority of her pregnancy there and received top-quality prenatal care, as well as preparation for the arrival of her twins.

UC Davis Hospital later said in the press release that they practiced for the surgery relentlessly. They utilized simulations and practiced almost every scenario in which something could go wrong. On the date of December 30th, the twins arrived into the world and were sent to the Neonatal Intensive Care Unit before heading home. A press release states that the twins spent almost seven weeks in that unit before they were medically cleared to return home.

Although the twins were doing fine during their time at home, there would be complications further down the line. As they aged, their shared organs and blood vessels would become more entwined, meaning that they would become heavily reliant upon one another. In this scenario, the twins would suffer plenty of internal conditions and had a frightening risk of early death.

The hospital stated that such conditions were very rare, and a successful separation surgery was even more so. In addition to practicing simulations of the surgery, the team of neurosurgeons had created 3D models of the fused skulls. They used mixed reality goggles to look inside of the skulls and determine how to best separate them. This was challenging because one small mistake could result in horrible consequences.

Before the girls left the hospital after seven weeks, tissue expanders were placed underneath the skin of their heads. Thes expanders would assist the skin in growing and promote quick recovery after the surgery. When the time finally arrived for the surgery, a team of over 30 medical professionals was already trained and ready to go. The team was led by the director of anesthesiology, Rajvidner Dhamrait, Children’s Surgery Center nursing lead Aida Benitez, and a few other highly qualified professionals.

The procedure was an intricate process where the twins shared veins and brain matter would have to be separated. In addition, the skulls would have to be reconstructed and altered to recreate healthy skulls. The Chief of Plastic surgery Granger Wong later stated that the surgery was similar to a choreographed ballet, in which each person played their part perfectly and everything was rehearsed prior to the big day. After nearly 10 months of extensive preparation, the girls were finally separated and ready for their journey to recovery.

The team at UC Davis claims that they will always remember the day when they successfully separated the twins and hopes that the twins will come back to visit one day. While the girls are in recovery, Liliya has no shortage of thanks for the team and is hopeful that her daughters will live long and healthy lives. Caring for the twins has been a learning process for her, however, she has been doing exceptionally well thus far.

Liliya agrees that with the twins separated, her duties will become much easier. While she is grateful for the surgery, she does not want her daughters to forget their childhood, and as such, she has documented their journey so that she may show it to them when they are older. UC Davis Hospital has recently completed a successful separation surgery of conjoined twins. After 10 months of preparation, including simulations and 3D models, the team was grateful to have successfully separated the twins. The twins are now living separate lives under the care of their loving mother.

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