At one point, Pedro and Augusto, born conjoined at the head, were on “the edge of organ failure,” one of their doctors said

After successfully removing conjoined twins from Central America over a year ago, medical professionals at a children’s hospital in Ohio are speaking out.

Dayton Children’s Hospital reports that it took two years and four major operations to separate Guatemalan twins Pedro and Augusto, who were born conjoined at the head.

According to Good Morning America, the boys, who are now 5 years old, underwent a three-day procedure on April 8, 2022, to formally separate them.

Dr. Robert Lober, a pediatric neurosurgeon who assisted with the twins’ separation, said the final surgery became more complex after doctors realized separating a large artery connecting the twins could potentially have serious impacts on Augusto’s speech and motor skills.

“It took a personal toll,” Lober said to GMA. These were boys that we had all grown to like over a considerable amount of time. They grew to be our boys.

Doctors at the medical center Dayton Children’s Hospital first learned about Pedro and Augusto’s condition in 2019, according to GMA.

The two were “joined at the top of the head with a 90 degree turn” — which the hospital said is called “craniopagus O’Connell class III.”

“There is very little research or practical knowledge in medical literature about how to separate craniopagus twins, especially those who are connected at this angle,” Lober said in a news release from the hospital announcing a documentary about the twins’ separation.

But Dr. Christopher Gordon, chief of craniofacial and plastic surgery at Dayton Children’s, said doctors had to balance speed and caution in order to keep the twins alive.

At one point, the boys were teetering on “the edge of organ failure” due to the changes their bodies underwent following the procedures, Gordon told GMA. 

However, Pedro and Augusto remained “incredibly strong” throughout the complicated process, according to the doctor.

The twins returned home to Guatemala in June 2023, and are now living as separate individuals, Dayton Children’s Hospital said.

Their story will be featured in the film Connected: The Story of the Seemingly Impossible Separation of Pedro and Augusto.