UK neurosurgeon leads first-of-its kind surgery to separate conjoined twins

One-year-old conjoined twins have been successfully separated after surgery in Turkey led by a renowned British neurosurgeon.

Minal and Mirha underwent challenging operation completed in two stages, with the final procedure lasting 14 hours.

The surgery at the Ankara Bilkent City Hospital was led by Great Ormond Street Hospital neurosurgeon Professor Noor ul Owase Jeelani.

The separation was completed over three months, with the final surgery taking 14-hours / Credit: Great Ormond Street Hospital

The twins are continuing to recover in hospital, with both expected to make a full recovery when they return home this month.

The twins were born in Pakistan with a rare pre-natal condition resulting in them being born conjoined at the head. This meant they shared vital blood vessels.

The case was referred to the team at Gemini Untwined – a charity founded by Professor Jeelani that conducts research and life-saving operations for craniopagus twins – in October 2023, when the twins were just a few weeks old.

“It is an honour to be part of this team who have successfully completed Gemini Untwined’s eighth separation of craniopagus twins,” said Professor Jeelani.

“To be able to give these girls and their family a new future where they can live independently and enjoy their childhood is a special privilege.

The parents of Minal and Mirha / Credit: Great Ormond Street Hospital

“This was truly a global effort, with twins from Pakistan being separated in Türkiye with expertise and support of a UK based team with professions from seven different countries,” he added.

In preparation for the complex surgical procedure, the medical teams used mixed reality to guide and train the surgeons.

Mixed reality combines 3D digital content with the physical world, and allows users to interact with digital elements, like 3D patient scans, while staying aware of their real surroundings.

Immersive technology allowed surgeons to visualise and rehearse the complex procedure, improving precision and safety / Credit: Great Ormond Street Hospital

The XARlabs platform, which was developed by neurosurgery resident and PhD student Ali Rezaei Haddad, was used to develop a high-fidelity 3D model of the case for Gemini Untwined.

This was used to help train the local team in Ankara on what to expect in the operating theatre, as well as helping the UK-based team to prepare and rehearse the surgery.

Experts created highly detailed 3D model of the twins’ anatomy / Credit: Great Ormond Street Hospital

Commenting on the use of mixed reality software to train the surgeons, Professor Jeelani said: “The technology developed to undertake this work makes a lot of the more routine surgeries we do, safer, less invasive and more effective, thus benefitting thousands of children within the UK and globally.”