Conjoined twins attached at the head with fused brains have been successfully separated with the help of virtual reality (VR) technology. This remarkable feat marks the sixth successful separation surgery of craniopagus conjoined twins ever performed in the world and one of the most complex separation processes to date.
The twins, 3-year-old Brazilian boys named Bernardo and Arthur, were separated over seven separate surgeries in Rio De Janeiro, the final two of which took over 33 painstaking hours.
More than 100 medical staff were involved in the operations, which were led by Noor ul Owase Jeelani, a UK neurosurgeon from Great Ormond Street Hospital, London and co-founder of the charity Gemini Untwined, alongside Dr Gabriel Mufarrej, Head of Paediatric Surgery at Instituto Estadual do Cérebro Paulo Niemeyer.
“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. It is through this process of teamwork and knowledge-sharing globally that we can hope to improve the outcome for all children and families that find themselves in this difficult position,” Jeelani said.
“This is only possible through generous donations from members of the public."
It was a groundbreaking separation of many firsts. At almost four years old, the boys are the oldest craniopagus twins with a fused brain to be separated. It’s also the first operation of its kind to be carried out in Latin America.
Conjoined twins are exceptionally rare, occurring in just 1 in 60,000 births, of which just 5 percent of those are fused at the skull, medically known as craniopagus twins.
The boys’ operations were especially tough because of the fusion of the brain and the sharing of several key veins. Prior to the separation, other experts dismissed it as too risky given the intense complexity of the case, so the team was forced to put in a huge amount of preparation.
To get ready for the monumental operation, the medical teams spent months testing and trialing techniques using VR simulations of the twins based on CT and MRI scans.
“This is the first surgery of this complexity in Latin America,” said Mufarrej.
“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. We are delighted that the surgery went so well and the boys and their family have had such a life-changing outcome."