Rare Craniopagus Twins Successfully Separated After 50-Hour Surgery

On February 11, 2019, conjoined twins Safa and Marwa Ullah were successfully separated after a marathon 50-hour surgery at Great Ormond Street Hospital (GOSH) in London, UK. This groundbreaking procedure involved the collaboration of 100 experts and doctors.

The twins, Safa and Marwa, were born in 2017 in Pakistan, and their mother was unaware that she was carrying conjoined twins. They were delivered via cesarean section and shared a skull and blood vessels, a condition known as craniopagus conjoined twins. After some time, they were transferred to the UK, where a medical team in London, including specialists in neurosurgery, psychology, X-ray, physical therapy, spent four months researching and planning the treatment for the twins.

Prior to the final major surgery, the twins had already undergone three separate surgeries. According to the doctors at Great Ormond Street Hospital, this was an extremely rare and complex procedure, with a survival rate of approximately one in ten million for craniopagus twins. Noor ul Owase Jeelanim, a neurosurgical consultant and one of the leaders of the surgical team, explained that the key to the successful complex surgery was dividing it into multiple stages for better control.

To aid in the surgical planning, the doctors used virtual reality technology to create an accurate anatomical model of the twins’ skulls, including the position of their brains and blood vessels.

“In the first two to three hours, our main focus was on separating the twins’ shared skull,” said Jeelanim.

During the surgery, the twins experienced bleeding, and Marwa’s heart rate dropped, putting her at risk of death. To ensure her survival, the doctors decided to prioritize the crucial vein that both twins shared and give it to Marwa. As a result, Safa suffered a stroke 12 hours later but was promptly treated and saved.

After successfully completing this stage, the team used bone from the twins’ skulls combined with tissue expansion technology to reconstruct their scalp.

Following the separation surgery, the twins were discharged on July 1, and their overall physical condition was deemed satisfactory, although they still face many challenges ahead. Marwa and Safa are currently living with their mother in London and undergoing daily physical therapy.

This historic surgery marks the first successful separation of conjoined twins’ heads in Europe.