Twin girls, conjoined at the skull, successfully separated in 18-hour operation in Italy.

Ermine Nzotto holds her twins Ervina and Prefina, at the Vatican paediatric hospital in Rome on June 30, 2020.

Ermine Nzotto holds her twins Ervina and Prefina, at the Vatican paediatric hospital in Rome on June 30, 2020.

Bambino Gesu / AP

A rare congenital defect, a rare surgery and a miraculous separation of two twin girls, joined at the skull.

Mom Ermine Nzotto can now breathe a sigh of relief after her twin baby girls, Ervina and Prefina Bangalo, were successfully separated after two years of living conjoined at the back of their heads, the Associated Press (AP) reports.

They were separated in an 18-hour surgery at the Vatican’s pediatric hospital on June 5, a painstaking procedure to separate critical blood vessels around their brains that they’d both been sharing.

After recovering from their three surgeries, including their final definitive one, doctors at the Bambino Gesu Paediatric Hospital announced on Tuesday that it was successful.

Such cases of conjoined twins, the AP says, occur once in around every two million births. According to CNN, this successful operation is the first of its kind in the world.

The team described it as “one of the rarest and most complex forms of fusion,” and spent a year preparing for the surgery.

Mariella Enoc, the hospital’s president, met the family in the Central African Republic in July 2018 and brought them for treatment in Rome.

The first stage of their separation was in May 2019, the second in June 2019 and the final one last month.

“It was an exciting moment, a fantastic, unrepeatable experience,” Carlo Marras, head of neurosurgery at the hospital, told CNN. “It was a very ambitious goal and we did everything to achieve it, with passion, optimism and joy.”

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Before the separation surgery, members of the Vatican hospital’s staff gave the girls mirrors so they could see one another. They each knew what the other sounded like, but the mirrors helped them associate facial expressions with their personalities and sounds, Marras told the AP.

“It was an experience that wasn’t just professional but above all human: to think that you can arrive at something that we had only imagined, with all the possibilities of failure. It was a magical moment. Marvellous,” he said.

The hospital says the twins’ brains are fully intact and they will likely go on to develop motor and cognitive skills as normal.

“Ervina and Prefina were born twice. If we had stayed in Africa I don’t know what fate they would have had,” Nzotto said. “My little girls can now grow up, study and become doctors to save other children.”

© 2020 Global News, a division of Corus Entertainment Inc.

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