Conjoined twins successfully separated with AI assistance

A pair of craniopagus twins have made a full recovery after separation surgery, thanks to the collaboration of over 60 experts from four countries and the application of artificial intelligence.

Mercy and Goodness, craniopagus twin sisters, were successfully separated using pioneering artificial intelligence (AI) techniques, People reported on 19/6/2023. The two girls were born in Ekiti state, Nigeria, in 6/2023 with fused skulls, shared brain tissue, and blood vessels. At six months old, the sisters were transferred to Gemini Untwined, a UK-based charity specializing in supporting craniopagus twins.

Craniopagus twinning is an extremely rare birth defect, accounting for approximately 5% of all conjoined twin cases. According to a representative from Great Ormond Street Hospital in London, UK, the incidence of this anomaly is one in 2,5 million births. Of these, about 40% of fetuses are stillborn or die during labor, and one-third of cases result in death within the first 24 hours after birth.

Mercy and Goodness with their parents after successful separation surgery. Photo: Gemini Untwined

Mercy and Goodness with their parents after successful separation surgery. Photo: Gemini Untwined

According to Gemini Untwined, in 2025, Mercy and Goodness were brought to Abu Dhabi in the United Arab Emirates (UAE). There, the two girls underwent multiple medical interventions at SEHA Sheikh Khalifa Medical City. Following detailed planning and extensive clinical assessment, the medical team performed a series of staged interventions over four months, with the final surgery lasting 12 hours.

This marked Gemini Untwined's ninth successful craniopagus twin separation surgery. The endeavor brought together over 60 medical experts from four countries: the UK, UAE, Brazil, and Nigeria, with teams collaborating closely at each stage of the process. The twins were 19 months old at the time of their separation and have since fully recovered, returning to their home country, Nigeria.

The surgery incorporated several new and improved techniques, including the involvement of artificial intelligence. According to the BBC, doctors used scanning applications to build detailed simulated images of the girls' brains, allowing surgeons to practice the procedure in a mixed reality environment prior to the actual operation.

The surgical team with Mercy and Goodness. Photo: Gemini Untwined

The surgical team with Mercy and Goodness. Photo: Gemini Untwined

Additionally, medical experts applied the "Open Book" method, a technique that utilizes gravity to support the brain, minimizing pressure and reducing the risk of brain tissue damage compared to using traditional steel retractors.

According to The Times, AI technology also assisted in calculating the placement of silicone skin expanders on the girls' heads earlier than in previous surgeries. This method allowed the scalp to grow sufficiently to cover the new skull, completely eliminating the need for skin grafts after the operation.

Professor Noor ul Owase Jeelani, co-founder of Gemini Untwined and the lead pediatric neurosurgeon for the operation, commented, "The techniques we develop in these cases are constantly being refined, making surgeries safer and more effective." He added that over time, these efforts not only improve treatment outcomes for craniopagus twins but also contribute to broader advancements in pediatric surgery.

He described this as a "milestone" separation, "planned and executed with unprecedented precision." "Inheriting experience from eight previous cases, combined with new techniques and strategies, we were able to give these two girls and their family a new future, where they can enjoy childhood as independent but whole individuals", the professor stated.