A team of multidisciplinary clinicians at the Texas Children’s Hospital, Houston, Texas, United States, worked for six hours separating a set of conjoined twins after they were delivered via caesarian section at a different hospital.

The twins are getting ready to head home as separate individuals for the first time one month after the surgery.

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They were delivered via Caesarean section from their mother, Sandy Fuller, who learned they were conjoined during the second trimester of her pregnancy. Fuller was referred to Texas Children’s Fetal Center where she underwent extensive prenatal testing and imaging to determine if separation of the twins was possible after birth.

The four-month-old twin girls, Ella and Eliza Fuller, were born in March but spent the first months of their lives in the neonatal intensive care unit at Texas Children’s Hospital in Houston, Texas.

An hour after their delivery, the twins were transferred to Texas Children’s Hospital where they spent the next three months preparing for their separation surgery.

The twins underwent a six-hour surgery June 14, according to a release from the hospital. A multi-disciplinary team of 17 clinicians worked to separate them. The twins were conjoined at the abdomen and shared liver tissues.

After the surgery, Ella and Eliza returned to the neonatal intensive care unit to recover. Three days later, their parents, Sandy and Jesse Fuller, were able to hold them separately for the first time.

“Texas Children’s Hospital was a place of comfort and hope for our family,” Sandy Fuller said in a release provided by the hospital.

“From the beginning to the end, we were guided, informed and comforted. We are so grateful God put some of the best doctors and nurses in our lives to give our girls the best chance at life. We truly love Texas Children’s.”

Conjoined twins are rare, estimated to occur once in every 50,000 pregnancies, according to the Cleveland Clinic, and up to 60% are either stillborn or die after delivery. Conjoined twins are always identical, and more likely to be female.