Three-year-old twins Bernardo and Arthur Lima were separated by a medical team in Rio De Janeiro, Brazil, with the assistance of Great Ormond Street Hospital in London, becoming the oldest pair of craniopagus conjoined twins to have ever been separated.
The pair underwent seven surgeries, and the final surgery alone took 27 hours to complete, as well as the efforts of more than 100 medical professionals.
The team spent months practicing for the surgery using virtual reality projections of the twins, using both CT and MRI scans of the cranial area as a base. During the simulated surgeries, doctors from both countries wore virtual reality headsets and operated together in a “virtual reality room” for the first time.
Surgeon Noor ul Owase Jeelani described the procedure as “space-age stuff.”
“It’s just wonderful,” he said. “It’s really great to see the anatomy and do the surgery before you actually put the children at any risk. You can imagine how reassuring that is for the surgeons.”
Jeelani explained that prior attempted surgeries had left considerable scar tissue near the conjoined area and complicated further attempts to separate the boys.
Jeelani is the founder of the charity Gemini Untwined, which funded the operation, and has separated five additional pairs of conjoined twins while working with the group. He led the procedure alongside Dr. Gabriel Mufarrej, the head of pediatric surgery at Instituto Estadual do Cerebro Paulo Niemeyer.
Mufarrej explained that the aforementioned hospital had cared for the two boys for most of their lives.
“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 have become part of our family here in the hospital. We are delighted that the surgery went so well.”
The twins’ heart rate and blood pressure reportedly skyrocketed after their separation and only dropped back down four days later when they were reunited and allowed to touch hands. The twins are reportedly recovering well and will spend the next six months in the hospital for rehabilitation.
Conjoined twins are rare, accounting for about one in 60,000 live births, and their long-term survival rates are often very poor. The phenomenon occurs when a fertilized egg in a woman’s body splits into two embryos but does not separate entirely, leaving the identical twins connected by shared tissue. Separating them can be uncomplicated or impossible, depending on where their bodies join and what organs they share. Craniopagus conjoined twins are joined at the head, the rarest kind of conjoined twins.