A British surgeon has successfully separated Brazilian twins who were born with fused brains.
Three-year-olds Bernardo and Arthur Lima have undergone a number of surgeries with the help of Great Ormond Street Hospital paediatric surgeon Noor ul Owase Jeelani, and are now finally separated.
They are also the oldest craniopagus twins with a fused brain to have been separated.
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According to the charity that funded the operation, Gemini Untwined – which Mr Jeelani founded in 2018 – the operation was one of the most complex ever completed.
The surgeon said that for the first time ever, medics in separate countries wore headsets and operated in the same 'virtual reality room' together, which Mr Jeelani described as 'space-age stuff'.
Speaking about using virtual reality, Mr Jeelani says: “It’s just wonderful, 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. In some ways these operations are considered the hardest of our time, and to do it in virtual reality was just really man-on-Mars stuff.”
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Mr Jeelani explained that the procedure was complicated further by previous unsuccessful attempts to separate the boys, which meant their anatomy was complicated by scar tissue.
After the surgery, he explained he was 'absolutely shattered' but was feeling 'over the moon' for the family.
“There were a lot of tears and hugs,” he says. “It was wonderful to be able to help them on this journey.”
Mr Jeelani also confirmed that the boys are now recovering well.
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Speaking of the incredible charity that funded the procedure, Mr Jeelani adds: “The idea behind the charity was to create a global health service for super-rare cases to try and improve results for these kids.
“The model of what we have done, I think, can and should be replicated for other super-rare conditions.”
This was Mr Jeelani’s sixth separation procedure with Gemini Untwined, after previously operating on twins from Pakistan, Sudan, Israel, and Turkey.
The procedure was led alongside Dr Gabriel Mufarrej, head of paediatric surgery at Instituto Estadual do Cerebro Paulo Niemeyer in Brazil.
Dr Mufarrej says: “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.
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“We are delighted that the surgery went so well and the boys and their family have had such a life-changing outcome.”
According to the charity, one in 60,000 births result in conjoined twins, and only five percent of these are joined at the head – known as craniopagus children. It is thought that 50 such sets of twins are born around the world every year and only 15 survive beyond the first 30 days of life.
With current technologies, which the charity aims to make more accessible, it is thought that around half of these cases would be eligible for successful surgical separation.
"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," says Mr Jeelani.
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"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.
"This is only possible through generous donations from members of the public."
Lucy Devine