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Brazilian twins who shared fused brains at the head have successfully separated with the help of virtual reality.


Surgeons spent months trialing techniques using virtual reality before beginning the real procedures on the three-year-old Brazilian boys.


Bernardo and Arthur Lima underwent several surgeries in Rio de Janeiro, under the direction of UK-based pediatric surgeon Noor ul Owase Jeelani from London's Great Ormond Street Hospital.


The three-year-olds had seven surgical procedures, involving more than 27 hours of operating time in the final operation and almost 100 medical staff.


Their surgery was led by Mr Jeelani, alongside Dr Gabriel Mufarrej, head of paediatric surgery at Instituto Estadual do Cerebro Paulo Niemeyer.


It was one of the most complex separation procedures ever conducted, according to the charity that funded it- Mr. Jeelani founded in 2018 - Gemini Untwined.


Mr. Jeelani defined the operation as a "remarkable achievement" by medics but added the charity, Gemini Untwined, relies on public donations to keep its work going.



He said: "The successful separation of Bernardo and Arthur is a remarkable achievement by the team in Rio and a fantastic example of why the work of Gemini Untwined is so valuable.


He said that previously unsuccessful attempts to separate the boys meant their anatomy was complicated by scar tissue, and he was "really apprehensive" about the risky procedure.


Mr. Jeelani stated he was "absolutely shattered" after the 27-hour operation, where he took only four 15-minute breaks for food and water. But, it was "wonderful" to see the family feeling "over the moon" afterward.


"There were a lot of tears and hugs," he said. "It was wonderful to be able to help them on this journey."


He added that as with all conjoined twins after separation, the boys' blood pressures and heart rates were "through the roof" - until they were reunited four days later and touched hands.


The charity has fast become a "global repository for knowledge and experience" of separation surgery and, hopes it will serve as a model for a "global health service" providing expert care in other rare diseases.


"The idea behind the charity was to create a global health service for super-rare cases to try and improve results for these kids," he said.


"The model of what we have done, I think, can and should be replicated for other super-rare conditions."


Their work was funded by Gemini Untwined, a charity founded by Mr. Jeelani to raise funds for siblings born joined at the head - called craniopagus twins.


Since the twins are almost four years old, they are also the oldest craniopagus twins with a fused brain to have been separated.


Both twins are recovering well in hospital and will be supported with six months of rehabilitation, the charity has said.


According to Gemini figures, one in 60,000 births results in conjoined twins, and only 5% of these are craniopagus children.

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