Doctors in St. Louis have successfully separated Ethiopian two-year-old twin girls who were born joined at the head after a months-long series of complex operations culminating in a nearly 25-hour final procedure, doctors said on Wednesday (September 16).
Hiyab and Wuhbto, who were born as craniopagus twins, underwent six major surgeries over several months before the final separation operation in February 2026,
"Our team has performed a series of six complex neurologic and plastic and reconstructive surgeries, concluding with a definitive nearly 24-hour separation procedure," Dr. Andrew White, chief pediatrician at Sisters of Saint Mary (SSM) Health Cardinal Glennon Hospital said at a news conference on Wednesday.
The announcement, months after the twins' separation surgery was timed to ensure the twins met health benchmarks for rehabilitation.
Video released by the hospital showed the sisters as infants joined at the head and playing with rattles while under the care of doctors and nurses.
The girls traveled from Mekelle, Ethiopia, to the United States in 2025 with support from children's healthcare charities and arrived in St. Louis for treatment.
Doctors said one of the biggest challenges was separating an extensive network of veins shared by the twins.
"Largely what these girls shared was a very large network of connected veins that spanned around their skulls," said neurosurgeon Dr. Joanna Kemp. "In order to successfully separate them, we had to dedicate some of these veins to one twin and some to the other."
The team carried out four staged procedures to divide blood vessels gradually and allow each child to develop independent circulation. Kemp said doctors were forced to adjust their timetable after encountering a brief episode of twin-to-twin blood flow imbalance following an early vascular separation surgery.
Plastic surgeon Dr. Kevin Chen said reconstruction of the girls' skulls was among the most difficult parts of the operation. Surgeons preserved sections of bone removed during earlier procedures and later used them in the reconstruction.
Building Wuhbto's cranium involved "jigsawing a lot of pieces and matching them in the best way possible," Chen said.
Following the separation, the twins spent time recovering at Ranken Jordan Pediatric Bridge Hospital. Later images and video showed the sisters wearing protective helmets, playing with toys and attending follow-up appointments with doctors.
Chen said rehabilitation remains ongoing but doctors are encouraged by the girls' progress. "We're very pleased with how they're going," he said.
(Production and writing: Deborah Gembara)