Conjoined twins separated with the help of virtual reality in Brazil

Conjoined twins, who were born in Brazil with fused heads and brains, were separated in an operation doctors described on Monday as the most complex operation of its kind, preparing them to use virtual reality.

Arthur and Bernardo Lima were born in 2018 in Roraima state, northern Brazil, as craniopag twins, an extremely rare condition in which the siblings are fused at the skull.

Bandaged at the top of the head for almost four years – most of which they spent in a Rio de Janeiro hospital equipped with a custom-made bed – the brothers can now face each other for the first time after a series of nine surgeries , which culminated in a 27-hour marathon operation to separate them.

London-based medical charity Gemini Untwined, which helped perform the procedure, described it as the “most challenging and complex separation yet” as the boys shared several vital veins.

“The twins had the most severe and difficult version of the disease with the highest risk of death for both,” said neurosurgeon Gabriel Mufarrej of the Paulo Niemeyer State Brain Institute (IECPN) in Rio, where the procedure was performed.

“We are very happy with the result because at first no one believed in this operation, but we always believed there was a chance,” he said in a statement.

Members of the medical team, which included nearly 100 employees, used virtual reality to prepare for the delicate final stages of the surgery on June 7 and 9, Gemini Untwined said.

Using brain scans to create a digital map of the boys’ common skull, the surgeons practiced for the procedure in a transatlantic virtual reality trial operation.

British neurosurgeon Noor ul Owase Jeelani, the lead surgeon on Gemini Untwined, called the virtual reality prep session “space-age stuff.”

“It’s just wonderful, it’s really great to be able to see the anatomy and do the surgery before you actually put the kids at risk,” he told Britain’s PA news agency.

“You can imagine how reassuring that is for the surgeons… Doing it in virtual reality was just really Man on Mars stuff.”

Pictures and video released by medical workers showed the boys lying side-by-side on a hospital bed after the operation, and little Arthur reached out to touch his brother’s hand.

Tearfully, the boys’ mother Adriely Lima described the family’s relief.

“We’ve been living in the hospital for almost four years,” she said.