A groundbreaking surgical procedure has successfully separated 19-month-old conjoined twins who were attached at the skull. The twins, Mercy and Goodness, from Nigeria, have made full recoveries and returned home after the complex operation, led by British paediatric neurosurgeon Professor Noor ul Owase Jeelani.
The 12-hour surgery took place at Sheikh Khalifa Medical City in Abu Dhabi and was performed by an international team of medical professionals from the UAE, the UK, Brazil, and Nigeria. Professor Jeelani, who also founded the UK-based charity Gemini Untwined, described the separation as a “landmark case” executed with unprecedented precision.
This procedure marks a significant advancement in the surgical treatment of craniopagus twins, a rare condition where twins are conjoined at the skull. The operation involved four separate surgeries over four months, with more than 60 healthcare staff from 20 different nationalities contributing. The twins were born in June 2023 in Nigeria’s Ekiti State and were referred to Gemini Untwined at six months old.
The surgical team utilized advanced techniques and technologies, including 3D imaging, virtual reality simulations, and augmented reality overlays, to map the twins' complex shared blood vessels and brain tissue. A key innovation was the 'open book technique,' which uses gravity to prevent brain collapse and reduce trauma. AI modeling also played a role in the placement of silicone expanders beneath the twins’ scalps, creating sufficient skin coverage without the need for grafts.
Gemini Untwined is the world's only charity exclusively dedicated to treating craniopagus twins. The organization has built on nearly two decades of experience in similar cases to develop novel strategies for these highly complex separations. Conjoined twins occur in approximately one in 2.5 million births, with craniopagus twins representing a small fraction of these cases. Tragically, mortality rates for craniopagus twins are high, with many stillborn or dying shortly after birth.