Doctors at the Vatican’s pediatric hospital in Rome announced on Tuesday that they successfully separated conjoined twins whose skulls were fused together back-to-back. The extremely rare condition occurs once in every two million births and the girls shared critical blood vessels around their brains.
Ervina and Prefina Bangalo were born on June 29, 2018, in Mbaiki, Central African Republic. The Vatican hospital, Bambino Gesu, is part of the public Italian health care system and has a strong relationship with the pediatric hospital in Central African Republic’s capital of Bangui. In 2015, Pope Francis visited the hospital and has been supportive of the collaboration.
Soon after the twins were born, hospital president Mariella Enco met them and began working hard to get the girls to Rome to see if they could be separated. There were both ethical and economical concerns due to the high cost of the procedure ($1.1 million) that some argued could have been spent on less-risky procedures to help more children. But, she said, “When you find a life that can be saved, you have to save it.”
Dr. Carlos Marras, chief of pediatric neurosurgery at Bambino Gesu, spent two years planning how the separation would occur. Since the back of the head holds a large portion of the blood supply to the brain as well as the drainage to move blood away, the surgery was complicated and would be performed in steps.
“[The goal was] to obtain a separation with the girls in perfect condition,” said Marras. “So the objective we gave ourselves was very ambitious, and we did everything to reach it.”
Since the girls could hear each other but not see each other, the hospital staff had given them mirrors to be able to not only see each other but be able to match facial expressions with the other’s voice.
The girls underwent three surgeries, including one in May and one in June of 2019, and the final one on June 5, 2020. Marras explained that the biggest complication they faced was to ensure that each sister received an autonomous venous drainage system. The final surgery took 18 hours, making use of 3-D imaging and neurostimulators, and involved 30 members of the medical staff. The twins will need to do some rehabilitation, but, after the surgery was completed, Marras said, “These girls can have a normal life.”
“It was an experience that wasn’t just professional but above all human: to think you can arrive at something that we had only imagined, with all the possibilities of failure. It was a magical moment. Marvelous,” said Marras.
The girls’ mother, Ermine Nzotto, said she hopes her daughters will have the opportunity she didn’t have to attend school and to become doctors themselves. She also hopes Pope Francis will baptize them.
“It’s a joy, that I can see my girls run and play like other children,” she said. “May they tomorrow study and learn to become doctors to save the other children of this world.”
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