How these conjoined twins were separated in Saudi Arabia during one of the world’s most complex surgeries

Dubai: Filipino conjoined twins joined at the head have been successfully separated in Saudi Arabia after an intricate and high-risk operation described by doctors as “one of the most complex cases worldwide.”

The surgery, which lasted for 18 and a half hours, has been carried out at King Abdullah Specialised Children’s Hospital in Riyadh by a team of 30 consultants, specialists, and nursing and technical staff across multiple disciplines.

A complex case

In a statement, the King Salman Humanitarian Aid and Relief Centre (KSrelief) has noted that the twins, Klea Ann and Maurice Ann Misa, involved severe medical complications.

Dr. Abdullah bin Abdulaziz Al Rabeeah, supervisor general of KSrelief and head of the medical and surgical team of the programme, has revealed that Klea Ann was suffering from cardiac muscle insufficiency and severe kidney atrophy with complete renal failure, which further increased the complexity of the procedure.

“The twins' case is among the most complex in the world due to several medical factors, most notably the complex angular positioning of the two heads, extensive sharing of the cerebral venous sinuses, and intertwining of brain tissue between the two girls,” explained Al Rabeeah.

He has bared that the case carried significant risk even before surgery.

“Based on the multidisciplinary medical evaluation and precise diagnostic studies, the level of risk reaches 50 percent due to the medical challenges associated with the case, with the possibility of severe neurological complications that may result in disability at a rate of up to 60 percent.”

Five-stage surgical plan

The twins have arrived in Saudi Arabia on May 17 last year, and underwent a series of precise examinations, imaging tests, and medical consultations.

Following several discussions, the surgical team has developed a five-stage plan. The operation has been led by Dr. Muatasim Al-Zoubi, consultant paediatric neurosurgeon, and involved specialists in anaesthesia, intensive care, advanced imaging, neurosurgery, and plastic surgery.

Doctors have initially estimated the procedure to take up to 24 hours.

70th case under programme

In a post on X (formerly Twitter), KSrelief has announced the successful operation after nearly 13 hours of continuous surgery. 

“This marks the 70th operation in the programme’s history and the third case involving twins from the Philippines, with subsequent stages continuing for reconstruction and closure.”

The procedure has been performed under the Saudi Conjoined Twins Programme, which has handled 157 cases from 28 countries since 1990.

Family relief after surgery

Meanwhile, the twins’ mother has expressed relief after the success of the separation surgery. 

“Truly a miracle for our family. Our hearts are full of gratitude and happiness because we have prayed and waited for this moment for so long,” said the mother in a video.

She added, “To all the doctors, nurses, and the entire medical team, thank you for your dedication and compassion. You did not only perform surgery, you gave my twins a chance to live their lives separately.”