TWO-YEAR-OLD twin girls who are joined at the chest and abdomen have completed final preparations for a complex surgery at a California hospital that is meant to separate them.
Doctors at Stanford University's Lucile Packard Children's Hospital are planning a nine-hour procedure today that, if successful, will allow Angelica and Angelina Sabuco to live independently.
The girls were born in the Philippines and live in California with their family.
Pediatric surgeon Gary Hartman, who has performed five similar procedures, said he expected the twins to survive and do well. The operation will involve more than 20 physicians and nurses from various specialties, and it culminates several months of planning.
"I want them to live normally, like other children," Ginady Sabuco, the girls' mother, said in a statement from the hospital.
The girls have done well so far. They love listening to stories and music, and they know their colours and can count to 10. They celebrated their second birthday with cakes adorned with Disney princesses and Tinker Bell.
But remaining conjoined carries risks for the girls' health, especially if they share organs unequally. If one conjoined twin dies, the other will die within hours.
The girls' livers, diaphragms, breast bones, chest and abdominal wall muscles are fused. They have separate hearts, brains, kidneys, stomachs and intestines.
The occurrence of conjoined twins is estimated to range from 1 in 50,000 births to 1 in 100,000 births worldwide, and the overall survival rate is approximately 25pc, according to the hospital.
The operation will involve cutting along the girls' skin and muscle and separating their diaphragms and livers.
Dr Hartman said severing the liver will be the most risky part of the procedure because of potential blood loss. Doctors will then cut adhesions between the girls' bowels and snip any remaining skin. Separate reconstruction operations will follow. The girls are expected to be hospitalised for nearly two weeks.
Dr Hartman said he doesn't expect the children will need intense physical therapy following surgery but they may experience regression with some milestones.
"We expect they will have a little separation anxiety too," said Ruby Sabuco-Collins, the girls' aunt. "But we're just so proud of them now and so excited for them in the future."