The separation of conjoined twins with a combined skull and brain who were born in Brazil has been regarded by physicians as the most challenging procedure of its type. Arthur and Bernardo Lima were born in 2018 in the state of Roraima in northern Brazil with the unusual condition known as craniopagus twins, in which the brothers’ craniums are united.
The brothers, who were joined at the top of the head for almost four years and spent the majority of that time in a hospital in Rio de Janeiro equipped with a special bed, are now able to look each other in the face for the first time following a series of nine operations that culminated in a lengthy 27-hour surgery to separate them.
Given that the boys shared multiple important veins, the London-based medical charity Gemini Untwined, which assisted with the treatment, called it the ‘most challenging and complex separation to date’.
‘The twins had the most serious and difficult version of the condition, with the highest risk of death for both’, said neurosurgeon Gabriel Mufarrej of the Paulo Niemeyer State Brain Institute (IECPN) in Rio.
According to Gemini Untwined, the medical team, which was made up of close to 100 employees, used virtual reality to train for the delicate last phases of the procedure on June 7 and June 9.
In a trans-Atlantic virtual reality trial operation, doctors simulated the technique using brain scans to generate a digital map of the boys’ common skull.
The principal surgeon on Gemini Untwined, British neurosurgeon Noor ul Owase Jeelani, described the virtual reality prep session as ‘space-age stuff’.
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