Two-year-old conjoined twins from Ethiopia have been successfully separated following a complex 25-hour surgery at SSM Health Cardinal Glennon Children’s Hospital in St. Louis, Missouri, United States.
The girls, Hiyab and Wuhbto, were born with craniopagus, an extremely rare condition in which twins are joined at the head. In their case, the sisters were connected while facing in opposite directions, meaning they could hear each other but could not see each other’s faces.
The hospital announced their successful separation on Wednesday, several months after the high-risk operation was carried out in February. Surgeons had to carefully separate shared blood vessels and address areas where the twins’ brains and skull structures were connected.
Craniopagus is among the rarest forms of conjoined twinning, accounting for less than six per cent of all conjoined twin cases, according to the National Library of Medicine. The condition occurs in approximately one in every 2.5 million live births.
Hiyab and Wuhbto were taken from Ethiopia to Missouri in 2025 after doctors determined that remaining joined could create significant long-term health risks. Their case required extensive preparation before surgeons could attempt the separation.
Nearly 30 medical specialists spent almost a year preparing for the operation, with the hospital describing the procedure as complex and high-stakes. The medical team had to plan how to separate the shared structures while preserving the girls’ brain function and managing the reconstruction required after the separation.
Dr Joanna Kemp, who led the surgical team, said the twins’ brains were mostly separate, although there were small areas where they were fused. This meant surgeons had to work carefully around the connected areas during the procedure.
Family remained in Ethiopia
The twins’ parents were unable to obtain visas to travel to the United States and therefore remained in Ethiopia while the girls travelled to Missouri with a guardian.
The hospital said the treatment was made possible through a global network of paediatric healthcare providers and charity organisations that supported the girls’ medical care.
Kemp, who is described as the first female neurosurgeon in the United States to perform this type of surgery, said the moment the twins were finally separated was remarkable for members of the surgical team.
She recalled that seeing the girls physically apart in the operating room created a moment of pause for those involved in the lengthy procedure, given the complexity of the operation and the preparation that had preceded it.
Recovery continues after separation
Following their separation, Hiyab and Wuhbto have continued their recovery and rehabilitation at Ranken Jordan Pediatric Bridge Hospital in Maryland Heights, Missouri.
The sisters still require additional medical procedures as part of their recovery. The hospital said Wuhbto has already undergone a successful cranioplasty to complete the repair of her skull.
Hiyab is expected to undergo a similar procedure later in the autumn as doctors continue the reconstruction and rehabilitation process.
The hospital described the girls’ progress as a major milestone in their surgical journey, while noting that their recovery remains ongoing.
The medical team hopes the sisters will eventually return to Ethiopia and reunite with their parents after completing the necessary treatment and rehabilitation in the United States.