Conjoined Twins Finally Home After Successful Operation

Twin girls from Pakistan joined at the skull have returned home after a successful operation at a London hospital in 2019.

Sara and Marwa Bibi were born with fused skulls and blood vessels—a condition known as craniopagus. It is the rarest type of conjoined twinning, occurring once in 2.5 million live births and 2 to 6 percent of conjoined twins. A majority of twins born with this condition do not survive beyond childhood as 40 percent are stillborn, and another one-third die within 24 hours.

3 operations and 50 hours later

In February 2019, the twins were separated following three operations at the Great Ormond Street Hospital (GOSH) in London. It took a team of 100 people and a total of 50 hours in the operating theatre.

The girls, who are now aged three and a half, had their first operation in October 2018, when they were just 19 months old. A private donor, Pakistani businessman Murtaza Lakhani foot the bill for Sara and Marwa's operation.

Finally, taking the girls back home

Speaking to BBC, the twin's mother, Zainab Bibi, said she was delighted to finally be taking the girls back home where their seven other children are eager to help care for the girls. They are doing well, and Marwa has made progress and just needs a little support.

She added that they would keep an eye on Zafra and "God willing," the girls will start walking. The girls with their mother and uncle had been living in London since the operation. Zainab's husband died of a heart attack while she was pregnant with the twins.

A surgeon's "near-impossible" choice

The lead surgeon, Owase Jeelani, said that he and the team were "very pleased" for the family, but he said he has some apprehensions about the operation's outcome. While Marwa did very well and made great progress, he said he is unsure if the family made the right decision for Safa.

The girls also share blood vessels that nourished both of their brains. Unfortunately, only one of the girls could receive key blood vessels. It was Marwa, who was the weaker of the two, who received these key blood vessels. That resulted in Safa having a stroke that permanently damaged her brain. She may never walk because of that.

It was a "near-impossible" choice that he and his team had to make then. Mr. Jeelani said it was a decision that he made as a surgeon and the one they made as a team. It's something that they will have to live with, he said.

Mr. Jeelani added that the operation's outcome would have been different had they had the operation much earlier - between six and 12 months old. This was the case for the twin boys from Turkey, who were also fused at the head. Yigit and Derman Evrensel's separation process was much faster, and they returned home before their second birthday.

Jeelani and fellow surgeon Prof David Dunaway established a charity organization called Gemini Untwined to raise awareness and funds to cover the cost of separating craniopagus twins.