- [Narrator] Two babies with two heads conjoined
will require one major surgery to make them separate.
- It's highly complicated from
a healthcare point of view,
it's highly complicated
from an anesthesiology point of view.
- [Narrator] Not all conjoined twins can be considered
for separation.
Abigail and Micaela can.
The girls are joined by the skull, brain, soft tissues,
veins and blood vessels.
Their surgery is scheduled to take place
at UC Davis Children's Hospital on October 24th,
when they're just shy of 10 months old.
The surgical team...
- It sits sort of high on your head.
- [Narrator] Is clear-eyed about the huge
amount of preparation to come.
At UC Davis, that means turning to the best high tech tools.
- Pretty much all of the latest technology available
we've had an opportunity
to try out and see how it will help us.
- [Narrator] Neurosurgeons upload the twins'
MRI and CT images into a system
that creates a three-dimensional virtual model,
allowing them to explore inside the babies' heads
with the use of mixed reality goggles.
- You can look from the top, the side, the bottom,
you can rotate the 3D model,
you can walk into the 3D model
and look backwards to see where you are.
- [Narrator] Now they can understand
the twins' unique anatomy from every possible angle.
The view inside the goggles
shows a complex network of blood vessels,
which the team will need to detangle and separate.
- With this clip do you think we can get quite proximal
maybe two clips here eventually as a plan?
- I think that's what I would do.
- Yeah.
- [Narrator] There are tangible models too.
- Luckily we exist in a time where there is this technology
that we can take CT scan data
and then generate it through the 3D printer,
a 3D model of the babies' skulls.
- [Narrator] With these 3D models, the team can plan
and practice the surgery.
- Maybe we wanna do like 75% of it.
- [Narrator] In the operating room
inside the UC Davis Children's Surgery Center...
- There's custom carts all built in the hallways..
- [Narrator] Months of preparation
culminate in a dry run,
or final rehearsal, on October 23rd,
the night before the surgery.
- Baby Orange is coding.
Surgeons cover the field.
Prepare to go supine.
- [Narrator] The anesthesia team prepares for any sudden
and dangerous complications.
A very real possibility
during a procedure as serious as this.
- There can be significant blood loss
and that blood loss, you can't really
give to one child or the other.
It could come from either,
it could come from both.
- One, two, three and move.
- [Narrator] The babies will need to change position
and be turned over several times during the surgery,
lifting them head over heels.
- Any piece of equipment can get entangled,
their bodies can get bruised,
they can bang against another surface,
so we are very careful about how we move patients.
That's with one patient.
Imagine two patients joined together.
- [Narrator] The team practices these precise movements
over and over.
With more than 30 people in the OR,
the team members are divided by color.
The leaders, neurosurgeon Michael Edwards,
plastic surgeon Granger Wong,
anesthesiologist Raj Dhamrait
and nursing lead Aida Benitez don black caps.
Not just any black caps.
- We were the guardians of the babies,
so we use guardians of the galaxy hats.
- [Narrator] The team in purple will take care of Micaela
while team orange cares for Abigail.
Purple and orange masking tape label the equipment
for the two teams in the operating room
- It is choreographed much as in a ballet
so that everybody knows their role at a given time,
and we've undergone rehearsals now for months
preparing for this case.
- [Narrator] Dhamrait and Benitez have led the OR team
through the months-long planning process.
They will serve as co-captains in the operating room.
- Essentially my job was done.
I had gotten everybody to that finish line
and all they needed to do was walk past it.
- [Narrator] It's now hours before the surgery.
The babies have breathing tubes inserted
and their mother Liliya says a tearful goodbye.
The big day is finally upon them.
(upbeat music)