Craniopagus Twins Connected By Brain Successfully Separated

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Twins Bernardo and Arthur Lima, 3, born conjoined at the head, can now look at each other face-to-face in time for their 4th birthday.

A medical team from Brazil and London worked together to separate the boys, who shared “vital veins” in their brains, during a series of surgeries, involving almost 100 medical professionals and 33 total hours in the operating room, according to a statement from the nonprofit Gemini Untwined.

 “We are delighted the surgery went so well,” Dr. Gabriel Mufarrej, head of pediatric surgery at Instituto Estadual do Cerebro Paulo Niemeyer in Rio de Janiero, Brazil, told the BBC. “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 have become part of our family here.”

Surgeons successfully separated 4-year-old conjoined twins Arthur and Bernardo Lima in Rio de Janiero. NBC News

In 2018, Adriely and Antonio Lima, who live in rural Brazil, welcomed twins, Arthur and Bernardo. The boys were born connected at the skull and sharing part of their brain, what’s known as craniopagus twins. For much of their lives, they lived at the Instituto Estadual do Cerebro Paulo Niemeyer hospital, receiving care from doctors and nurses who one day hoped to separate them, according to Gemini Untwined.

Their team in Brazil had reached out to experts around the world for help and many refused saying it was too difficult, Gemini Untwined said in a statement. Dr. Noor ul Owase Jeelani founded the nonprofit to train surgeons around the world how to separate craniopagus twins. He worked with the Brazilian team for months to train them and used a “virtual reality room” to operate in tandem, according to the BBC.  

“In some ways these operations are considered the hardest of our time,” Jeelani told the BBC. “To do it in virtual reality was just really man-on-Mars stuff.”

Image: Twins Arthur and Bernardo Lima sleep next to each other after a successful separation surgery in Rio de Janiero.
Twins Arthur and Bernardo Lima sleep next to each other after a successful separation surgery in Rio de Janiero.NBC News

Craniopagus twins are extremely rare occurring in one out of every 2.5 million live births and most twins don’t survive past their second birthday without being separated.

When Arthur and Bernardo were finally separated at nearly 4-years-old, they became the oldest twins to undergo such a surgery, according to Gemini Untwined.

“As a parent myself, it is always such a special privilege to be able to improve the outcome for these children and their families,” Jeelani said in a statement from Gemini Untwined. “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.”

Thanks to the training, the Instituto Estadual do Cerebro Paulo Niemeyer will become a partner with the UK-based organization and be able to provide these surgeries to other conjoined twins in South America.  

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