Twin sisters conjoined at the head have undergone an extremely complex and rare but successful separation surgery.
As PEOPLE reports, Hiyab and Wuhbto were successfully separated at SSM Health Cardinal Glennon Children’s Hospital in St. Louis. The cranial separation surgery, which began on Feb. 24, took more than 24 hours from start to finish. The siblings are currently in recovery and are receiving rehabilitation and intensive medical care.
The craniopagus twins first traveled to St. Louis from their birthplace in Ethiopia in March 2025, almost a year after they were born, the hospital said in a press release on Wednesday, Sept. 16. Wuhbto recently underwent a cranioplasty operation to finish the repair of her skull, the hospital said. Meanwhile, Hiyab is preparing for her cranioplasty to be performed later this fall.
The Missouri hospital called the surgery “one of the most complex and rare pediatric procedures performed in the United States.” According to Dr. Joanna Kemp, head neurological surgeon at SSM Health Cardinal Glennon, the girls are now able to participate in therapies that were impossible while they were conjoined.
The surgery marks a significant medical achievement, as conjoined twins occur in about one out of every 50,000 to 100,000 live births, with those joined at the head being even rarer. The operation was one of only 67 such procedures performed worldwide, and the first in the United States led by a woman.
Dr. Hossain Marandi, president of SSM Health Cardinal Glennon Children’s Hospital, said in a statement, “This story reflects the very best of who we are, bringing hope, healing, and opportunities once thought impossible to children and families when they need it most. From our caregivers and clinical teams to our community and global partners, countless individuals united around a shared mission to create new possibilities for these two young girls and their future.”
Several organizations banded together to support the twins. SSM Health Cardinal Glennon Children’s Hospital performed the surgery, while Ranken Jordan Pediatric Bridge Hospital has offered care before and after.
Additionally, World Pediatrics managed guardianship and consent, patient and family advocacy, international coordination and the volunteer caregiver network; Lola Children’s Home cared for the twins in Ethiopia; Ronald McDonald House Charities provided lodging and hospitality for their guardian; and Ethiopian Airlines arranged specialized transportation.
The hospital shared that over 300 hours were dedicated to planning and strategy meetings regarding the surgery. Furthermore, over 30 surgical staff were involved on the surgery day. The numbers continue to grow as over 100 staff are in the twins’ care team.
Dr. Nick Holekamp, chief health transformation officer at Ranken Jordan, gave insight into Hiyab and Wuhbto’s recovery process. “The girls are beginning to take full advantage of the miracle of their surgeries through a multidisciplinary therapy regimen at Ranken Jordan,” he said.
“They are now able to participate in individually focused therapies to do the activities of daily living that they could not do while conjoined, such as therapies to sit, eventually to stand and walk, to eat and speak, to socialize, and to play with other kids, including each other,” he continued. The doctor added, “Although they are still in the middle of an extensive medical journey, they are making progress toward one day pursuing independent lives.”
Twins joined at the head are incredibly rare. They are only found in 1 in 2.5 million live births and represent less than 6% of conjoined twins, per the National Library of Medicine. Only 62 separation attempts have been made worldwide.
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