7 a.m. The medical team takes conjoined twins Kendra and Maliyah Herrin, 4, to the operating room.
It's a tearful parting, both girls a little apprehensive and emotional. Parents Jake and Erin Herrin and the twins cry a little.
8:45 a.m. Doctors prepare the girls for the actual surgery. The draping process, including hooking up IVs and monitors, takes about two hours before the first incision. They spend most of that time making sure Kendra and Maliyah are stabilized under anesthesia and positioning them so that surgeons will have access as needed to both girls' small bodies.
10:45 a.m. The surgeons make the first incision. The first stage of the operation is a thorough examination of the pelvic area, which the girls share, to determine what needs to be done. The surgeons' plan is based on all the images from MRIs and CT scans, but they expect some surprises when they're actually inside. What they find will determine how much reconstruction they do during this operation. And that, in turn, determines how long the surgery will take.
1:30 p.m. So far, no surprises, according to Dr. Rebecka Meyers, coordinating surgeon and chief of pediatric surgery at Primary Children's Medical Center and University Hospital. The girls are stable, and seven hours into the surgery, doctors have not had to give the girls any blood.
Surgeons have successfully divided the large intestine. They now work on other organs in the pelvis. Typically, conjoined twins who are joined at the abdomen or pelvis share some organs, lack some and may have extra of others. But the Herrins have asked that very personal details about Kendra's and Maliyah's anatomy be kept private.
The surgical team is right on schedule and predicts the girls will be separated about midnight, at which time it will become two operations in adjacent rooms. They think they'll finish surgery about 4 a.m.
4:30 p.m. Urologists work on the girls' urinary tracts and bladders.
7 p.m. The girls' condition remains very stable, but doctors say the bladders are more complex than anticipated. There are two bladders, but each girl contributes one-half the blood supply, nerves and urine to each one. They have decided now how to assign the tissue but will not form the bladders until after the girls are separated. Then a separate team will work on each girl.
They work on dividing the liver right before separation.
10:50 p.m. The twins are separated. Now physicians work on the girls in two separate operations. The surgeries continue into early today.