Twin girls with fused skulls were successfully separated, doctors at the Vatican’s pediatric hospital announced on Tuesday.

The twins, Ervina and Prefina Bangalo, were born in 2018 in Mbaiki, Central African Republic, with their skulls attached, sharing critical blood vessels near their brains.

The Bambino Gesu Pediatric Hospital, which is Vatican-owned but operates within the Italian public health system, brought the twins and their mother to Italy soon after their birth.

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At a press conference, Dr. Carlo Marras, chief of pediatric neurosurgery at Bambino Gesu, said the girls are recovering well and they are expected to lead normal lives after a rehabilitation phase.

Ermine Nzotto holds her twins, Ervina and Prefina, after surgery.
The girls’ skulls were joined back-to-back in what the medical community calls “total posterior craniopagus.”

Detroit-area neurosurgeon and president of Jagannathan Neurosurgery, Dr. Jay Jagannathan, who was not involved in the surgery, told Fox News of the challenges involved in such a technical procedure.

“Pediatric brain surgery is especially challenging because the skull tends to be extremely vascular, meaning it has a lot of blood supply,” Jagannathan said. “A lot of times, in these cases where children are connected in the head, veins and blood vessels are often connected as well.”

“In addition to that, circulating blood volume in a child is significantly less than an adult. As a result, there’s much less room for error in terms of blood loss,” he said.

Jagannathan said the surgery requires a multidisciplinary approach. Alongside the neurosurgeon, plastic surgeons assist in wound closure and aestheticians manage patient stability and blood loss, among other health care professionals involved.

As for the success rate of these surgeries, there is a high degree of variability depending on the location of the conjoinment.