Sacramento twin girls conjoined by their heads were successfully separated at UC Davis Medical Center this weekend.
Nine-month-old Abigail and Micaela Bachinskiy underwent a marathon 24-hour surgery. The girls are joined by the skull, soft tissues and brain — known as craniopagus.
“It’s a very, very rare anomaly,” UC Davis Children’s Hospital Pediatric Neurosurgeon Dr. Michael Edwards said. “There are very few 𝘤𝘩𝘪𝘭𝘥ren 𝐛𝐨𝐫𝐧 in any one year worldwide that have this anomaly, and of those, there’s only a much smaller subset that the anatomy is fortuitous enough to be able to attempt a separation — and hopefully come out with two healthy babies.”
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Parent Liliya Miroshnik and Anatoliy Bachinskiy discovered the twins were conjoined when Liliya was 11 weeks pregnant.
“It was very tough. I just was shocked. I couldn’t process,” Miroshnik said. “When I got home my husband said that everything will be good. We will get through it. This is our kids. We already love them.”
The couple, who celebrated their 10th wedding anniversary in August, have three boys in addition to the twins.
“I still feeling like I am living someone else’s life and not mine,” Miroshnik explained. “It’s so crazy, I don’t even know how to describe to be honest. But I do know that we trust Lord in all of these situations. So, that brings me peace. But my other side, inside me, go crazy as a mother.”
The girls will be 10 months old on Friday.
“They both are really happy babies. Not fussy ones. Very happy, always laughing, smiling, positive,” Miroshnik said. “(They are) very different. One is more dominating. But the other is more like a lady — very calm, very gentle. But the other is very active. She is a leader for sure.”
After a few months at home in Sacramento County, the twins were re-admitted back into UC Davis Medical Center in June to prepare for surgery.
“We’ve spent a lot of time — five months — studying this from all different ways,” Dr. Edwards explained. “We’ve made 3D models. We’ve looked at some form of altered reality, virtual reality, augmented reality to help us understand the anatomy better.”
Meticulous preparation included virtual reality dry runs, as well as a mock separation surgery with dolls conjoined like Abigail and Micaela. The preparation was fine tuned down to color coding the medical team purple and orange—a color for each 𝑏𝑎𝑏𝑦.
“It is choreographed much as in a ballet or any state production so that everybody knows their role,” UC Davis Pediatric Plastic Surgeon Dr. Granger Wong said. “Now we can actually have a model and actually do the surgery on the model beforehand. So, all this practice and all this planning can go into the operation before it even happens– therefore taking out a lot of the guesswork.”
The conjoined twins also went through a tissue expander procedure four months before surgery to ensure each has enough skin following separation.
“Where they are joined together, there is no skin currently, and we will have to replace skin on both twins once they are divided,” Dr. Wong explained. “It’s made specifically to fit these dimensions, to fit in this little trough where the babies are connected. And then this will gradually increase in size.”
The tissue expander was injected with medical sterile saline.
“Which would then expand the scalp. And once the scale is up to full dimensions of what we’ve already planned, we know that we have gained the necessary skin to cover the voids after separation,” Dr. Wong said. “We have a certain window that we would like to take advantage of — just developmentally.”
The twin girls will be weeks at the Pediatric Intensive Care Unit (PICU) continuing to heal and defy odds.
“It’s very new. No one knows how it’s going to end. Because it is very unique, and it all depends how they will go, what their bodies will go through. I have a feeling everything will be OK,” Miroshnik said. “It’s all in God’s hands. It’s not even in doctor’s hands. That’s what I believe.”
Miroshnik added they have already met a family in a similar situation. In 2016, Sacramento conjoined twins Erika and Eva Sandoval were separated by their torso at Lucile Packard Children’s Hospital Stanford.
The Sandoval twins are now 6 years old and are thriving first-graders.