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Conjoined twins are quite rare, but it's even rarer that they would be conjoined at the head. Three-year-old twins Bernardo and Arthur Lima from Brazil were born with fused brains, but now they have been successfully separated thanks to a pediatric surgeon in the UK. And not only were they successfully separated, but they were operated on by a team of doctors around the world who worked together in the same “virtual room.”
After 27 hours of surgery, the complex operation was completed—making Bernando and Arthur the oldest set of craniopagus twins to be separated. Everything was made possible thanks to Gemini Untwined, a non-profit started by Dr. Noor ul Owase Jeelani of England's Great Ormond Street Hospital. Dr. Jeelani, who guided the operation, began the non-profit in 2018 to pool knowledge and resources around the world to execute these complex surgeries.
“The idea behind the charity was to create a global health service for super-rare cases to try and improve results for these kids,” he shares. “The model of what we have done, I think, can and should be replicated for other super-rare conditions.”
Bernando and Arthur had been operated on in the past, but prior surgeries were unsuccessful. This complicated the procedure even further, as there was scar tissue to contend with. Luckily, thanks to virtual reality, surgeons around the world could rely on each other to help the twins and their family.
The twins sat for a total of seven surgeries at the Instituto Estadual do Cerebro Paulo Niemeyer in Rio de Janeiro. The final two surgeries were attended by nearly 100 medical professionals and lasted a total of 33 hours. In order to ensure the success of the procedure, the medical team trained for months in order to master the virtual reality program used. They also did run-throughs of the surgery based on the twins' MRIs and CT scans.
Dr. Jeelani called the use of the technology “space-age stuff,” but pointed out how critical it was to have a large team working together.
“It's just wonderful, it's really great to see the anatomy and do the surgery before you actually put the children at any risk,” he explains. “You can imagine how reassuring that is for the surgeons. In some ways, these operations are considered the hardest of our time, and to do it in virtual reality was just really man-on-Mars stuff.”
While the team of doctors was exhausted by the extensive surgery, their hard work paid off when they delivered the good news to Bernando and Arthur's family.
“Since the parents of the boys came from their home in the Roraima region to Rio to seek our help two-and-a-half years ago, they had become part of our family here in the hospital,” shares Dr. Gabriel Mufarrej, head of pediatric surgery at Instituto Estadual do Cerebro Paulo Niemeyer in Brazil.
Dr. Mufarrej, who led the procedure, adds, “We are delighted that the surgery went so well and the boys and their family have had such a life-changing outcome.”
The twins, who were reunited after a four-day recovery period, are doing well. And now, there is hope for the future that the same methods can be used in even more surgeries.
“As a parent myself, it is always such a special privilege to be able to improve the outcome for these children and their family,” admits Dr. Jeelani. “Not only have we provided a new future for the boys and their family, we have equipped the local team with the capabilities and confidence to undertake such complex work successfully again in the future.”