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.

DESCRIPCIÓN DE IMÁGENES

Doctors successfully separate conjoined twins after marathon surgery in Missouri

VIDEO SHOWS: VARIOUS OF CONJOINED TWINS BEFORE AND AFTER SEPARATION SURGERY, NEWS CONFERENCE WITH MEDICAL TEAM CARING FOR THE TWINS

EDITOR'S NOTE - NEWS CONFERENCE IS 'ACCESS ALL'

SHOWS: ST. LOUIS, MISSOURI, UNITED STATES (ARCHIVE - MARCH 10, 2025) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Must courtesy ‘SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL.’ No resales.)

1. DOCTORS USING STETHOSCOPES TO CHECK ON CONJOINED TWINS HIYAB AND WUHBTO

2. VARIOUS OF TWINS PLAYING WITH RATTLES

ST. LOUIS, MISSOURI, UNITED STATES (ARCHIVE) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Must courtesy ‘SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL.’ No resales.) (MUTE)

3. STILL PHOTO OF TWINS BEING ATTENDED TO BY MEDICAL TEAM

4. STILL PHOTO OF ONE OF THE TWINS

MARYLAND HEIGHTS, MISSOURI, UNITED STATES (ARCHIVE - APRIL 29, 2026) (RANKEN JORDAN PEDIATRIC BRIDGE HOSPITAL – Must courtesy "RANKEN JORDAN PEDIATRIC BRIDGE HOSPITAL” No resales.)

5. VARIOUS OF TWINS POST-SURGERY LYING IN BED

ST. LOUIS, MISSOURI, UNITED STATES (SEPTEMBER 16, 2026) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Access all)

6. DR. ANDREW WHITE, CHIEF PEDIATRICIAN AT SSM HEALTH CARDINAL GLENNON WALKING UP TO PODIUM AT NEWS CONFERENCE

7. (SOUNDBITE) (English) DR. ANDREW WHITE, CHIEF PEDIATRICIAN AT SSM HEALTH CARDINAL GLENNON, SAYING:

“We are proud to announce the successful surgical separation of twin girls who were born conjoined at the head, facing opposite directions. Over the last, many, many months, our team has performed a series of six complex neurologic and plastic and reconstructive surgeries, concluding with a definitive nearly 24-hour separation procedure here at Cardinal Glennon Children's Hospital.“

8. WIDE OF NEWS CONFERENCE

9. (SOUNDBITE) (English) DR. JOANNA KEMP, NEUROSURGEON AT SSM HEALTH CARDINAL GLENNON, SAYING:

"Largely what these girls shared was, a very, you know, how many that model there? (HOLDS UP MODEL SHOWING VEINS IN THEIR HEAD) A very large network of connected veins, that that spanned around their skulls. And this is just a model of that. But in order to successfully separate them, we had to dedicate some of these veins to one twin and some to the other. But that was going to change their blood flow in such a way that it put them at risk for strokes and put them at risk for other physiologic changes. In fact, we experienced a problem with twin twin transfusion briefly when after the first vascular separation, that we had to sort of pivot our time line a little bit to accommodate and fix that problem. So there was four of those surgeries just to separate the blood vessels, to give them time for new blood vessels to kind of form and, start to more adequately drain their own, blood supply back to their individual hearts, before they were ready for that final separation.”

MEKELE, ETHIOPIA (ARCHIVE) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Must courtesy ‘SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL.’ No resales.) (MUTE)

10. STILL PHOTO OF TWINS SURROUNDED BY THEIR PARENTS AND STAFF AT THE LOLA’S CHILDREN’S HOME FOR THEIR SEND OFF TO THE U.S.

ST. LOUIS, MISSOURI, UNITED STATES (ARCHIVE - MARCH 10, 2025) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Must courtesy ‘SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL.’ No resales.) (MUTE)

11. STILL PHOTO OF DR. ANDREW WHITE GREETING TWINS AS THEY ARRIVE FOR ONE OF THEIR FIRST SURGERIES

ST. LOUIS, MISSOURI, UNITED STATES (ARCHIVE - SEPTEMBER 30, 2025) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Must courtesy ‘SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL.’ No resales.)

12. DR. PHILIPPE MERCIER, NEUROSURGEON AT SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL AND KATE CORBETT OF WORLD PEDIATRICS WITH TWINS

13. CORBETT SPEAKING TO TWINS (WITH SHAVED HEADS) BEFORE SURGERY

ST. LOUIS, MISSOURI, UNITED STATES (ARCHIVE - FEBRUARY 24, 2026) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Must courtesy ‘SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL.’ No resales.)

14. SURGEONS SCRUBBING UP FOR SEPARATION SURGERY

15. TWINS BEING WHEELED INTO OPERATING ROOM

16. BLOOD PRESSURE MONITOR

17. DR. KEMP IN SURGERY

18. IV (INTRAVENOUS) STAND IN OPERATING ROOM

19. VARIOUS OF DOCTORS PERFORMING SURGERY IN OPERATING ROOM

ST. LOUIS, MISSOURI, UNITED STATES (SEPTEMBER 16, 2026) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Access all)

20. (SOUNDBITE) (English) DR. KEVIN CHEN, PEDIATRIC PLASTIC SURGEON, HOLDING MODEL OF CRANIUM, SAYING:

“In order to access the brain, we had to get access through the bone itself. And we saved all of that bone that we took off at that time because we knew we were going to have to replace and cover the bony reconstruction at one point. So we did use the majority of the bone for the most recent surgery for Wuhbto. And then Hiyab was going to get a different kind of cranial reconstruction. But because it was all in pieces, it was a very, very challenging, reconstruction of the cranial vault, which basically involved jigsaw laying a lot of pieces in the match in the best way possible.”

21. WHITE FLASH

22. (SOUNDBITE) (English) DR. KEVIN CHEN, PEDIATRIC PLASTIC SURGEON, SAYING:

“I think we're very hopeful in their recovery overall that - is in the not too distant future. A lot of the actual rehabilitation is still an ongoing process, but we're very pleased with how they're going, and it's hard to say without having undergone the next big surgery for Hiyab.”

ST. LOUIS, MISSOURI, UNITED STATES (ARCHIVE - JUNE 18, 2026) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Must courtesy ‘SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL.’ No resales.)

23. DR. KEMP WITH ONE OF THE SISTERS IN WHEELCHAIR, THE OTHER SISTER BEING HELD

24. STAFF SAYING “HI” TO TWINS DURING CHECK-UP

25. VARIOUS OF TWINS WEARING HELMETS AND PLAYING WITH RATTLES

ST. LOUIS, MISSOURI, UNITED STATES (ARCHIVE) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Must courtesy ‘SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL.’ No resales.) (MUTE)

26. STILL PHOTO OF HIYAB AFTER SEPARATION SURGERY

27. STILL PHOTO WUHBTO AFTER SEPARATION SURGERY

ST. LOUIS, MISSOURI, UNITED STATES (ARCHIVE - JUNE 18, 2026) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Must courtesy ‘SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL.’ No resales.) (MUTE)

28. STILL PHOTO OF TWINS WEARING HELMETS IN WHEELCHAIRS DURING CHECK-UP APPOINTMENT

ST. LOUIS, MISSOURI, UNITED STATES (SEPTEMBER 16, 2026) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Access all)

29. (SOUNDBITE) (English) DR. PHILIPPE MERCIER, NEUROSURGEON AT SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL SAYING:

“Once we achieved, entry into the normal fluid filled pockets that they shared, we then stapled up the skin and were able to rotate them 180 degrees and in a very coordinated fashion, that was actually practiced with models and dolls and people, because we had to keep them sterile as we turned them around and not lose their IVs, their intubation, in a very coordinated fashion, we're able to turn around and achieve the same separation, eventually joining the two. And once the final staples were removed, the two beds were split and then rotated 180 degrees away from each other so that the two full, surgical teams could continue closure. The entire process was 24-25 hours."

ST. LOUIS, MISSOURI, UNITED STATES (ARCHIVE - SEPTEMBER 11, 2025) (SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL – Must courtesy ‘SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL.’ No resales.)

30. DOCTORS AT PLANNING MEETING

31. MODEL OF THE BRAIN ON TABLE

32. DR. KEMP POINTING TO IMAGE OF BRAIN ON SCREEN