Separating sisters Safa and Marwa Ullah required three major operations and a number of small procedures. The major operations totalled more than 50 hours of surgery time, took place over a four-month period and involved a 100-strong team at the world leading hospital. The first operation took place in October 2018 and the last operation, which saw the girls finally separated, took place on 11 February this year.
The two-year-olds from Charsadda in Pakistan, who were born by caesarean section, were craniopagus twins which means they were fused at the head – an incredibly rare condition.
Due to Great Ormand Street Hospital’s (GOSH) reputation as one of the only hospitals in the world with the expertise and experience to separate and care for craniopagus twins, the girls were brought to the London-based hospital from Pakistan for treatment when they were 19-months old.
The GOSH surgical and medical team, who also successfully separated craniopagus twins in 2011 and 2006, had the expertise and facilities to meticulously plan and carry out the series of complex and challenging operations and provide the high-level care Safa and Marwa needed.
GOSH experts used cutting-edge technology such as Virtual Reality (VR) and 3D printing to decide the best strategy and optimise chances of success. An exact replica of the girls’ anatomy was created in VR to help the surgeons visualise and understand the complex skulls and spatial relation between brains and blood vessels. 3D plastic models of the brains, skulls and blood vessels were then printed for practicing the surgery and building cutting guides to make the operations as smooth as possible.
The state-of-the-art technology and surgical techniques used for Safa and Marwa’s operations now give GOSH an opportunity to discover innovative ways of advancing clinical care and the clinical and research knowledge base that will benefit more children and young people in the future.
The 100-strong team was led by two world-leading surgeons. They were neurosurgeon Mr Noor ul Owase Jeelani and craniofacial surgeon Professor David Dunaway. The team included staff from over 15 disciplines across the hospital including plastic surgeons, anaesthetists, theatre nurses, operational department assistants, scientists and engineers with expertise in 3D modelling, VR technology and simulations.
The team also included dedicated paediatricians, ward nurses and allied health professionals including physiotherapists, occupational therapists and dietitians, who all played a vital part in the care and rehabilitation of the girls following their operations.
“We are indebted to the hospital and to the staff and we would like to thank them for everything they have done. We are extremely excited about the future,” said Zainab Bibi, the twins’ mother.
Mr Jeelani, who was Head of Neurosurgery at GOSH from 2012 to 2018, and Professor Dunaway, Head of the Craniofacial Unit at GOSH, said: “We are delighted we have been able to help Safa and Marwa and their family. It has been a long and complex journey for them, and for the clinical team looking after them. From our personal point of view, it has been great to get to know the girls and their family. Their faith and determination have been so important in getting them through the challenges they have faced. We are incredibly proud of them.”
The girls were discharged from GOSH on 1 July. They were transferred to a London address with their mother, grandfather and uncle where they continue to receive daily physiotherapy treatment as part of their ongoing rehabilitation.