Global NewsSurgeons Use Virtual Reality To Separate Conjoined Twins

Surgeons Use Virtual Reality To Separate Conjoined Twins


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Brazilian and previously conjoined twin brothers Arthur and Bernardo Lima were welcome with an emotional outpouring of applause, cheers and tears from medical staff and family members after successfully going through multiple surgeries.

Surgeons Use Virtual Reality To Separate Conjoined Twins

The boys lay separated, for the first time, face-to-face and holding hands in a shared hospital bed in Rio de Janeiro, after doctors there and almost 6,000 miles away in London worked together using virtual reality techniques to operate on the conjoined 3-year-olds.


The highly complex medical procedure separated the twins, who come from Roraima in rural northern Brazil and were born craniopagus, meaning they were connected to each other with fused skulls, intertwined brains and sharing vital veins in the brain. Only 1 in 60,000 births result in conjoined twins, and even fewer are joined cranially.

Medical experts had called the surgery to separate the brothers impossible.

But medical staff from the Rio’s Instituto Estadual do Cérebro Paulo Niemeyer worked with London-based surgeon Noor ul Owase Jeelani of Great Ormond Street Hospital to use advanced virtual reality technology to rehearse the painstaking procedure.

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It involved detailed imaging of the boys’ brains including CT and MRI scans, as well as checks on the rest of their bodies. Health workers, engineers and others collated data to create 3D and virtual reality models of the twins’ brains to allow the teams to study their anatomy in greater detail.

The international teams then spent months working to prepare for the procedures, according to the British charity Gemini Untwined, which facilitated the surgery and was founded by Jeelani, a renowned British-Kashmiri neurosurgeon.

The surgical teams conducted a cross-continental “trial surgery” using virtual reality, the first time such technology had been used for this purpose in Brazil, according to the charity. They went on to perform seven surgeries to fully separate the twins, involving hours of operating time and nearly 100 medical staff.

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“The separation was the most challenging to date,” Gemini Untwined said in a statement Monday. “At almost four years old, Arthur and Bernardo were also the oldest craniopagus twins with a fused brain to be separated, bringing added complications.” The optimal age for separation is between 6 and 12 months old, it said.

Although the successful surgery took place in June, the teams of doctors held off publicizing it so they could focus on the boys’ recovery, Francesca Eaton, a spokeswoman for Great Ormond Street Hospital, said Wednesday.

Craniopagus conjoined children have typically never sat up, crawled or walked before and require intensive rehabilitation post-surgery. Arthur and Bernardo will undergo six months of rehabilitation at the hospital and look forward to celebrating their fourth birthday together soon, Gemini Untwined said, “finally able to see each other face to face,” alongside their parents Adriely and Antonio Lima.

Jeelani, a specialist in separating craniopagus twins, called it a “remarkable achievement.”

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