A pair of twins born conjoined at the head are recovering at home after a team of doctors performed more than 50 hours of surgery to separate them, a London hospital announced Friday.
Safa and Marwa Ullah were born two years ago in Pakistan with the incredibly rare condition, the Great Ormond Street Hospital said in a news release. Only one in every 2.5 million births results in conjoined twins, and only 5% of those twins are fused at the head, according to the hospital.
The twins were brought to London at 19 months old. There, the surgical and medical team, who previously separated twins fused at the head in 2006 and 2011, created a detailed plan to determine how best to separate them.
Four operations, 55 hours of operating time – and a fond farewell! After 9 months of care, the twins and their family left GOSH on 1 July. Safa and Marwa have a long road ahead – but we are hopeful they will be able to live active, happy lives! https://t.co/aKrOCMGu3q 👋💗 pic.twitter.com/pWd6PXcFyq
— Great Ormond Street Hospital (@GreatOrmondSt) July 15, 2019
An exact replica of the girls' anatomy was created using virtual reality to help surgeons visualize the complex skulls, brains and blood vessels, while 3D models were printed for practicing the surgery and making cutting guides.
The team of 100, led by neurosurgeon Noor ul Owase Jeelani and craniofacial surgeon David Dunaway, performed three major operations and a number of smaller procedures over a four-month period.
The final operation successfully separated the girls on February 11, and they were released to their mother on July 1. The twins' treatment was paid for by a generous donor.
Jeelani explained in a video released by the hospital that while separating the babies is a complex procedure, the secret to success is breaking down the process into smaller more manageable steps.
The first few surgeries focused on separating the brains and blood vessels, according to the video. Once that was done, a piece of plastic was put between the two brains, internally separating the babies.
Doctors then focused on stretching the skin, reconstructing the top of their skull with their own bone and then covering their skulls with the expanded skin.
During one of the operations, clots formed in Safa's neck veins causing the girls to bleed, the Guardian reported. Marwa's heart rate dropped and doctors worried they might lose her.
To prevent this, they gave Marwa a key vein the twins shared, according to the newspaper, but as a result, Safa had a stroke less than 12 hours later.
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The girls must continue daily physiotherapy treatment as part of their rehabilitation, but Jeelani is optimistic that they will be walking by their third birthday.
“We are indebted to the hospital and to the staff and we would like to thank them for everything they have done. We are extremely excited about the future," the girls' mother Zainab Bibi said in a statement.
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This article originally appeared on USA TODAY: Conjoined twins separated after 50 hours of surgery in London