PHILADELPHIA (AP) — Twin brothers who were born conjoined recently celebrated their first birthday after undergoing successful separation surgery.

Amari and Esthen ExchangeJavar Ruffin, whose family lives in Philadelphia, were born via cesarean section on Sept. 29, 2023. The brothers — who shared part of their sternum, diaphragm, abdominal wall and liver — weighed a combined 6 pounds.

On Aug. 21, a surgical team at Children’s Hospital of Philadelphia with more than two dozen specialists, including surgeons, anesthesiologists, radiologists, nurses, and many others, operated for eight hours to separate the boys. Their abdomens were closed and rebuilt using layers of mesh and plastic surgery techniques.

The boys went home on Oct. 8 to be with their parents, Tim and Shaneka, and their siblings, Kaylum and Anora.

“Seeing them each in their own beds was an indescribable feeling,” Shaneka Ruffin said. “It feels like we are beginning a new journey as a family of six. We are so grateful to CHOP for helping make this day possible and letting us start this next chapter.”

The Ruffins learned the twins were conjoined through a routine ultrasound 12 weeks into the pregnancy. Shaneka Ruffin said it was recommended to her that she terminate her pregnancy. They got a second opinion, and the hospital told them that though the boys had a rare condition, they could be separated successfully.

Conjoined twins occur roughly once in every 35,000-80,000 births. The hospital is one of only a few in the U.S. with expertise in separating them.