Mercy and Goodness

Mercy and Goodness were born in Nigeria’s Ekiti State, joined at the head with fused skulls and shared brain tissue and blood vessels. At six months old, they were referred to the Gemini Untwined team.

In 2025, they travelled to Abu Dhabi, United Arab Emirates, where their treatment was carried out at SEHA Sheikh Khalifa Medical City in partnership with PureHealth.

Following extensive planning and clinical assessment, the team performed a series of staged procedures over 4 months, with the final surgery lasting 12 hours.

This case marked Gemini Untwined’s ninth successful separation of craniopagus twins, and the first to take place in the UAE. It brought together more than 60 healthcare professionals working across four countries – the UK, UAE, Brazil and Nigeria – with teams collaborating closely at every stage of the process. The twins, aged 19 months at the time of surgery, have since made a full recovery and will be returning home to Niegria.

What set this surgery apart was the use of several new and refined techniques developed through Gemini Untwined’s global work.

These included an ‘Open Book’ approach, which uses gravity to support the brain during surgery rather than traditional retractors, helping to reduce pressure and potential trauma. The team also introduced earlier, more gradual tissue expansion, informed by modelling and analysis, thereby removing the need for skin grafts during recovery.

For the first time, implants were designed using mixed reality technology. By overlaying CT scan data into detailed 3D models, surgeons were able to plan the reconstruction with
greater clarity before entering the operating theatre. In the months leading up to the final procedure, the team used a combination of 3D imaging, virtual reality simulation, augmented overlays and ultrasound-guided expansion to map the twins’ anatomy in detail, collaborating across multiple countries in a shared virtual environment.

The success of this case reflects nearly two decades of experience, with each separation contributing to a more refined and consistent approach to what remains one of the most complex procedures in paediatric neurosurgery.

Professor Jeelani added, “The techniques we develop in these cases continue to evolve, helping to make surgeries safer and more effective. Over time, this work is contributing not only to better outcomes for craniopagus twins, but also to wider advances in paediatric surgery.”

Gemini would like to extend our thanks to the UAE senior leadership for making this possible and for hosting the girls and their parents throughout their treatment and surgeries.