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The Saudi Press Agency reported that the operation got underway at the Riyadh facility under the directives of King Salman bin Abdulaziz Al Saud and Crown Prince Mohammed bin Salman. Dr. Abdullah Al Rabeeah, supervisor general of the King Salman Humanitarian Aid and Relief Center and head of the Saudi Conjoined Twins Program, is leading the surgical team. The agency said 34 consultants, specialists, technical staff and nurses are participating in the procedure, which has been structured into nine distinct stages. Officials described the case as one of the more intricate separations the program has undertaken.
The twins arrived in the Kingdom on July 21 following royal directives that arranged for their transfer and full sponsorship of care, according to a statement from Al Rabeeah. Comprehensive medical examinations and multidisciplinary consultations determined that the girls are joined at the abdomen and pelvis while sharing the liver, intestines, colon, anus, urinary system, reproductive system and pelvic bone. Al Rabeeah said in the statement that the assessment confirmed the need for a carefully sequenced surgical approach to address the multiple shared structures. The evaluation process also accounted for the twins’ overall stability before scheduling the operation.
Al Rabeeah stated that the procedure is considered complex with an estimated success rate of 70 percent based on the medical assessment. The Saudi Press Agency noted that this case represents the first separation of conjoined twins from Fiji undertaken by the program. Program data places the operation as the 74th separation performed under the Saudi Conjoined Twins Program since its establishment. The statement highlighted the team’s preparation drawing on experience accumulated across dozens of prior international cases.
Fiji’s Ministry of Health and Medical Services previously reported that the twins were born prematurely in September 2025 as part of a set of triplets, one of only two publicly documented conjoined twin births in the Pacific nation over the past 50 years. RNZ reported that authorities in Fiji had approached medical centers in several countries including the United States, United Kingdom and Mexico, each of which quoted costs exceeding one million dollars for the procedure. The Saudi offer to cover the entire cost of surgery, travel and accommodation for the family and a accompanying pediatric registrar enabled the twins to reach Riyadh for treatment, the broadcaster added.
The Saudi Conjoined Twins Program has evaluated more than 140 cases from nearly 30 countries over the past three decades, according to figures Al Rabeeah has cited in earlier program updates. Arab News reported that the initiative, which began in the early 1990s, maintains one of the highest volumes and success rates globally for such specialized pediatric procedures by concentrating expertise within a single dedicated team. Al Rabeeah has noted that the accumulated institutional knowledge allows the program to manage rare anatomical variations that many centers encounter only infrequently. Recent program statistics indicate steady growth in both evaluated cases and completed separations.
King Abdullah Specialist Children’s Hospital has hosted the majority of these operations, providing integrated facilities for preoperative imaging, intraoperative monitoring and postoperative intensive care, hospital officials have stated in past briefings. The current case follows similar humanitarian transfers including Jamaican and Syrian twins separated in prior years under the same royal directives and program framework. Al Rabeeah’s team has emphasized the importance of coordinated planning that incorporates input from pediatric surgeons, anesthesiologists, plastic reconstructive specialists and nursing staff throughout each phase.
