A British hospital operated two-year-old twins who were joined at the head. Doctors said on Tuesday that they have separated their skulls, brains, and blood vessels successfully.

Safa and Marwa Ullah were born in Pakistan in January 2017 with a condition known as “craniopagus”  in which the girls’ skulls and parts of their brains were joined and intertwined. The highly complex surgery involved multiple operations. 

David J. Dunaway, the co-led the surgical team, said: “Craniopagus is an exceptionally rare and complex condition.” He further stated that the operation conducted in February was the most complicated operation his team had ever performed to sate.

These kinds of twins are found one in a million births. The twins are joined at the head with fused skulls and separate bodies while having the connection extend into the brain tissue is rarer still. Every year, near about 50 sets of craniopagus twins are estimated to be born around the world of which only around 15 are thought to survive beyond the first 30 days of life.

Before the surgery, the surgeons had to use three-dimensional rapid prototyping images of the girl’s brains and blood vessels and to plan and practice the surgery in advance to minimize complications and it was helped by state-of-the-art technology.  The Great Ormond Street team said in a statement, “These cutting-edge scientific techniques greatly increased the chance of success for Safa and Marwa. Their brains were more intertwined than the previous sets of craniopagus twins making it the most complicated separation to date.”

The operation took place at London’s Great Ormond Street hospital, with the girls well enough to be discharged from hospital four months later on July 1. “These cutting-edge scientific techniques greatly increased the chance of success for Safa and Marwa. Their brains were more intertwined than the previous sets of craniopagus twins making it the most complicated separation to date,” the Great Ormond Street team said in a statement.

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