Conjoined twins have been successfully separated after three successive surgeries at a Vatican paediatric hospital, which described the procedure as a first-of-its-kind.

The two-year-old girls, Ervina and Prefina, were born totally conjoined at the back of the skull. Doctors at the Vatican-owned Bambino Gesu Pediatric Hospital said in a news conference that it was “one of the rarest and most complex forms of cranial and cerebral fusion.”

The two girls were born in Mbaiki, Central African Republic, on June 29, 2018. They were then taken to a children’s hospital in the capital, Bangui, which Pope Francis had previously visited in 2015. There they were overseen for a time by Mariella Enoc, president of Bambino Gesu, who proposed that they undergo surgery at the Vatican hospital in Rome.

Preliminary studies were then carried out for over a year back at Bambino Gesu hospital, which included advanced 3-D imaging and simulated surgeries. Tests showed that the twins were in good health but that one sister’s heart was having to work harder to physiologically balance the organs of both.

The greatest challenge facing doctors was that the two girls had an interconnected network of critical veins which moved blood from the brain to the heart. This required “three very delicate operations to progressively reconstruct two independent venous systems,” the hospital said.

The twins underwent the final operation on June 5, which took around 18 hours. The operation involved over thirty doctors and nurses, including specialist neurosurgeons, plastic surgeons, engineers, anaesthetists, neuro-radiologists, and physiotherapists.

The hospital said that the surgeons worked to divide the bones of the shared skull, before reconstructing the membrane covering each brain and recreating the skin lining over the skulls.

The girls’ mother, Ermine, spoke at a news conference of her relief and thanked everyone for their help. “Ervina and Prefina were born twice. If we had stayed in Africa, I don’t know what fate they would have had,” Ermine said.

“Now that they are separated and doing well, I would like them to be baptized by Pope Francis, who has always taken care of the children of Bangui. My little ones can now grow up, study and become doctors to save other children,” she added.

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