Rare conjoined twins connected by their skulls have been separated after 50 hours of operations at a London hospital.

Two-year-old sisters Safa and Marwa Ullah had to undergo three major operations at Great Ormond Street Hospital (GOSH) to separate their heads.

The first operation took place in October 2018, when the girls, from Charsadda, in Pakistan, were just 19 months old.

They were finally separated during their last operation on 11 February this year.

The girls’ mother, Zainab Bibi, 34, who has previously had seven children, said: “We are indebted to the hospital and to the staff, and we would like to thank them for everything they have done.

Conjoined twins joined at skull separated after 50 hours of operations Show all 4 1 /4 Conjoined twins joined at skull separated after 50 hours of operations Conjoined twins joined at skull separated after 50 hours of operations Two-year-olds Safa and Marwa Ullah, from Charsadda, in Pakistan, leaving Great Ormond Street Hospital after a surgery to separate their heads with their mother Zainab Bibi and their grandfather Mohammad Sadat. Great Ormond Street Hospital/PA Conjoined twins joined at skull separated after 50 hours of operations Safa and Marwa after a surgery to separate their heads. Great Ormond Street Hospital/PA Conjoined twins joined at skull separated after 50 hours of operations Safa and Marwa before the surgery to separate their heads. Great Ormond Street Hospital/PA Conjoined twins joined at skull separated after 50 hours of operations Safa and Marwa before the surgery to separate their heads. Great Ormond Street Hospital/PA

“We are extremely excited about the future.”

The girls, whose father died of a heart attack while their mother was pregnant with them, were discharged from hospital on 1 July.

They have now moved to an address in London with their mother, grandfather Mohammad Sadat Hussain, 57, and uncle, Mohammad Idrees.

The girls, who were born by caesarean section, were craniopagus twins, meaning their skulls and blood vessels were fused together.

GOSH had previously successfully separated craniopagus twins in 2006 and 2011.

Experts used virtual reality to create an exact replica of the girls’ anatomy so that they could visualise the structure of their skulls as well as the positioning of their brains and blood vessels.

A team also used 3D printing to create plastic models of the structures that could be used for practice, as well as cutting guides.

During the surgery, doctors first worked to separate the girls’ blood vessels and then inserted a piece of plastic into their heads to keep the brains and blood vessels apart.

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The final major operation involved medics building new skulls using the girls’ own bone.

The surgery, which was paid for by Pakistani businessman Murtaza Lakhani, has been followed by several smaller procedures which will enable the girls to live independent lives.

The operations added up to more than 50 hours of surgery time and involved 100 members of staff from GOSH.

Neurosurgeon Noor ul Owase Jeelani and craniofacial surgeon Professor David Dunaway led the team that operated on the girls.

Mr Jeelani, a neurosurgeon at GOSH, and Professor Dunaway, head of the hospital’s craniofacial unit, 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.

“Their faith and determination have been so important in getting them through the challenges they have faced. We are incredibly proud of them.

“We are also incredibly proud of the GOSH team responsible for their treatment and care over the past 10 months.”

Conjoined twins are very rare – affecting only about one in every 2.5 million births.