Saudi surgeons separate Somali conjoined twins in 14-hour operation in Riyadh
RIYADH — A Saudi medical team has successfully separated 13-month-old Somali conjoined twins in a complex 14-hour operation at King Abdullah Specialist Children’s Hospital in Riyadh, officials said Thursday, marking a milestone for the Saudi Conjoined Twins Program and new hope for the family.
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The twins, Rahma and Ramla, were joined at the lower abdomen and pelvis and shared critical organs, making the case among the more complex conjoined twin separations. The procedure unfolded in eight stages and drew on a multidisciplinary team of 36 consultants, specialists and technicians across pediatric surgery, anesthesia, urology, orthopedic surgery and plastic surgery.
Surgeons reported significant anatomical challenges: The girls shared a pelvis, large intestine and rectum, as well as parts of their urinary and reproductive systems. Although each child had two fully formed legs, both faced serious renal complications that elevated the risks. Medical assessments determined that Ramla had complete kidney failure and will require dialysis following the procedure. Rahma had one non-functioning kidney and another affected by fluid buildup, though it remained operational. Given those conditions, doctors had placed the success rate at about 40 percent prior to surgery.
The operation was led by Dr. Abdullah Al-Rabeeah, supervisor general of the King Salman Humanitarian Aid and Relief Center and head of the Saudi Conjoined Twins Program’s surgical team. With Thursday’s outcome, officials said, the program has recorded its 68th successful separation. Over the past 35 years, it has assessed or treated 156 sets of conjoined twins from 28 countries, underscoring Saudi Arabia’s sustained investment in complex pediatric care.
Rahma and Ramla were flown to Saudi Arabia in May last year after King Salman ordered their transfer for medical evaluation and potential treatment. After months of planning, imaging and simulation, the surgical team proceeded with the separation, prioritizing organ preservation, blood-flow stability and the safest possible division of shared pelvic and abdominal structures.
Doctors said the girls were separated safely, and they are now under close observation in intensive care. Post-operative priorities include pain control, infection prevention, wound management and careful nutritional support to aid healing. Specialists will oversee staged reconstructive procedures as needed. Ramla is expected to begin dialysis, and Rahma’s kidney function will be monitored closely to protect her remaining capacity.
Key facts from the operation:
- Duration: 14 hours, completed in eight planned stages
- Team: 36 consultants, specialists and technicians across five core disciplines
- Lead: Dr. Abdullah Al-Rabeeah, head of the Saudi Conjoined Twins Program
- Anatomy: Fusion at the lower abdomen and pelvis with shared intestinal, urinary and reproductive structures
- Risk: Pre-operative success estimate of 40 percent due to renal complications
The successful separation offers the twins a chance at greater independence and mobility as they grow, though both will require long-term follow-up to support development, continence, musculoskeletal alignment and renal health. Hospital officials said further updates on their condition and rehabilitation plan will be provided as they progress through recovery.
The Saudi Conjoined Twins Program, run under the umbrella of the King Salman Humanitarian Aid and Relief Center, has built an international referral footprint over three decades by combining advanced imaging, collaborative surgical planning and staged reconstruction protocols. Thursday’s result in Riyadh adds to that record, while highlighting the logistical and clinical coordination required for high-risk pediatric surgery involving shared organs.
The hospital did not release a detailed timeline for discharge. Clinicians emphasized that the coming weeks will focus on stabilizing the girls’ kidney function, assessing bowel and urinary control, and supporting wound healing before moving to longer-term rehabilitation.
Officials expressed cautious optimism about the twins’ immediate post-operative course, noting that the most delicate portion — a safe separation — has been achieved.
By Ali Musa
Axadle Times international–Monitoring.
