Medical experts had called the rare surgery to separate the brothers almost impossible.

Bernardo and Arthur Lima, three-year-old twin boys from Roraima, Brazil, were born conjoined at the head. As Craniopagus twins, they shared fused skulls, intertwined brains and vital veins.

Only 1 in 60,000 births result in conjoined twins and even fewer are joined cranially.

The Plan to Separate the Twins

Conjoined Lima twins in the hospital before surgery

Medical experts had called the rare surgery to separate the brothers impossible. But thanks to the work of London-based neurosurgeon Noor ul Owase Jeelani and the medical staff from Rio’s Instituto Estadual do Cérebro Paulo Niemeyer, the two boys are now separated and able to lead independent lives.

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Through the use of virtual reality, the surgical team was able to rehearse the comprehensive procedure months ahead of the surgery. The VR training programs allowed surgical teams from different countries to work together in the same “digital surgery suite” for the first time in history.

Dr. Jeelani conducted a series of seven historic procedures on the brothers, with the last two surgeries lasting 33 hours. Nearly 100 medical staff attended the operation, The Evening Standard reported.

Jeelani called the procedure a “remarkable achievement.”

The Most Challenging Separation to Date

Lima parents looking at their sons after surgery.

In 2018, Dr. Jeelani founded Gemini Untwined, one of the world’s leading organizations devoted to “the research and treatment of craniopagus twins around the globe.”

Since the organization’s launch, Dr. Jeelani and his team have successfully separated five sets of craniopagus twins.

Sadly, 40% of craniopagus twins are stillborn or die during childbirth, and 30% die within 24 hours of birth. 78% of craniopagus twins pass away before reaching the age of one year.

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“The separation was the most challenging to date,” Gemini Untwined said in a statement. “At almost four-years-old, Bernardo and Arthur were the oldest craniopagus twins with a fused brain (we have) separated, bringing added complications.” The optimal age for separation is between six and twelve months of age.

Once the twins had been separated successfully, Dr. Jeelani said that there was a flood of hugs, cheers and tears from the Lima family, as well as the medical staff.

A New Future for the Family

“We provided a new future for the boys and their family,” Jeelani said.

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“As a parent myself, it is always such a special privilege to be able to improve the outcome for these children and their family. 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,” Dr. Jeelani wrote in a statement published by The Independent.

“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.”


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