The 2-year-old twins, Safa and Marwa Ullah, were born with an extremely rare condition called craniopagus.

This means they shared a portion of their skull and brain tissue. Now, they have been successfully separated after a months-long medical endeavor that required more than 50 hours of major surgery and a team of 100 medical professionals.

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The two-headed conjoined twins before their operation at GOSH. Picture by Great Ormond Street Hospital

Conjoined twins are very rare to begin with, occurring at a rate of about 1 in 2.5 million births worldwide. Of these, only about 5% are craniopagus.

The twins were brought from their home in Pakistan to GOSH when they were 19 months old. They required three major operations that took place from October 2018 to February 2019. The girls’ recovery took time, and they were finally well enough to leave the hospital on July 1.

The complex surgeries to separate craniopagus twins need to be broken down into a series of smaller steps.

  • For the first several procedures, doctors focus on separating the twins’ brains and blood vessels
  • Then doctors insert a piece of plastic to separate the two brains.
  • Next, during another procedure, the skulls must be separated and the tops of their heads reconstructed with the twins’ own bone and skin.

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Twins Safa and Marwa Ullah after their surgery. Picture Great Ormond Street Hospital

To aid in planning the surgeries, doctors created a replica of the twins’ anatomy with virtual-reality technology, and they also used 3D-printed plastic models of the twins’ brains, skulls and blood vessels to practice the surgery.

We are delighted we have been able to help Safa and Marwa and their family. It has been a long and complex journey for them, and for the clinical team looking after them,” said Dr. Noor ul Owase Jeelani, former head of neurosurgery at GOSH.

The hospital separated two other sets of craniopagus twins, in 2006 and 2011.

That’s awesome! I am also happy for them!

[Gosh.nhs.uk, NY Times]

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