Two conjoined twin sisters, born with their heads joined, underwent complex separation surgery in February. They are currently recovering and undergoing rehabilitation, according to SSM Health Cardinal Glennon Children’s Hospital in St. Louis, Missouri, USA, which reported on Wednesday.
The operation, which lasted over 24 hours, took place on February 24th and 25th and was performed by a multidisciplinary team. It has been described as one of the rarest and most complex pediatric interventions performed in the United States.
Joanna Kemp, Chief Neurosurgeon at SSM Health Cardinal Glennon Children’s Hospital, noted at a press conference that while it is too early to speak about the girls' long-term development, they now have opportunities that would have been unavailable without this surgery.
Sisters Hiyaab and Ukhbt were born in Ethiopia but traveled to St. Louis in March 2025 before their first birthday to prepare for the surgical intervention. After the operation, they celebrated their second birthday and continue to recover from a series of complex surgeries, receiving continuous rehabilitation and intensive medical care with the support of over 60 members of the clinical team and various partner organizations.
Nick Holkamp, Director of Healthcare Transformation at Ranken Jordan Pediatric Bridge Hospital, emphasized that the girls can now participate in individual therapy and perform daily activities that were previously impossible, such as sitting upright. In the future, they may learn to stand and walk. They are already eating, talking, communicating, and playing with each other and with other children, moving towards an independent life despite the long medical journey.
Meanwhile, Ukhbt underwent cranioplasty surgery to complete skull recovery, and Hiyaab is preparing for a similar procedure scheduled for this autumn.
Data from the National Medical Library, provided by SSM Health Cardinal Glennon Children’s Hospital, shows that the birth of conjoined twins joined at the head occurs only once every 2.5 million cases and accounts for less than 6% of all conjoined twin cases. Out of 69 well-documented cases of craniopagus, 62 separation attempts have been made worldwide.
In addition to SSM Health Cardinal Glennon Children’s Hospital, which performed the surgery, organizations such as Ranken Jordan Pediatric Bridge Hospital, which provided care to the girls before the operation and continues to provide rehabilitation and complex therapeutic care, were involved. World Pediatrics was also involved, managing custody and consent, protecting the interests of the patients and families, international coordination, and a network of volunteers who supported the girls throughout the treatment.
Lola Children’s Home provided care for the children in Ethiopia, and the Ronald McDonald House Foundation provided accommodation for the caregiver, while Ethiopian Airlines guaranteed specialized transportation.