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Conjoined twins merge in brain that separates successfully

Bernardo and Arthur Lima are not like other twins – they were born conjoined, sharing not only the crown of the head and part of the brain, but also a major vein that connects to the heart.

Now, a groundbreaking surgery, performed in part by surgeons working together, has hopefully given the boys the chance to live like any other pair of brothers.

The couple had surgery just before their fourth birthday, making them the oldest twins with fused brains that have been successfully separated.

For months, surgeons in both the UK and Brazil have collaborated through a virtual reality theater to map out the best way to separate twins’ fused brains without functional impairment or cutting. cut those important veins.

By the time that work became a reality, it would have taken nearly 100 medical staff through seven surgeries.

Dr Noor ul Owase Jeelani, a pediatric neurosurgeon who led the surgery, said in a video posted by Gemini Untwined. Gemini Untwined is a charity that seeks to help craniopagus twins – children who receive a head transplant and have a fused skull and brain.

Jeelani is the co-founder of Gemini Untwined, which was founded in 2018, coinciding with the same year that Bernardo and Arthur were born in a rural town in Northern Brazil.

The two boys are grafted at the top of their heads, facing each other in opposite directions. While conjoined twins are already rare, craniopagus twins account for only 5% of all conjoined twins, meaning they occur once in 1.2 million births.

The twins’ parents, Adriely and Antonio Lima, took them to Rio de Janeiro, where a medical team at the Instituto Estadual do Cerebro Paulo Niemeyer cared for the twins for two and a half years.

The boys defied it – about 78% of craniopagus twins die before the age of one.

But after many experts said it was impossible to separate the boys, the hospital reached out to Gemini Untwined.

Their case is a difficult one for a number of reasons. Not only do they share important veins in the brain, but they are also nearly four years old. According to the Gemini Untwined website, the ideal age to separate craniopagus twins is between 6-12 months old.

Doctors scanned the twins’ skulls, brains and soft tissues to create a virtual mirror to study, even performing an experimental surgery across continents.

After many surgical procedures, the final surgery to separate the boys in Brazil was a grueling 27 hours, with countless prayers.

Video posted by Gemini Untwined shows the parents hugging the medical staff before surgery, and then the final moment the two boys are separated. Employees wipe away tears after their success.

“We just finished our double separation surgery. The surgery went really well. It’s a great, excellent team here with Dr Mufarrej,” Jeelani said in the video, gesturing to Dr Gabriel Mufarrej, chief of pediatric surgery at the Instituto Estadual do Cerebro Paulo Niemeyer, who helped lead the procedure. with him.

Another clip shows the twins being wheeled out of the operating room. Applause broke out and hugs were exchanged more.

It’s not over yet for the boys. This was just the beginning of six months of recovery in the hospital, and then more intense detox sessions. But the medical team is very hopeful.

“As a parent myself, it’s always been a special privilege to be able to improve outcomes for these children and their families,” Jeelani said in a statement. “We have not only provided a new future for the boys and their families, we have equipped the local team with the ability and confidence to successfully undertake such complex work once and for all. more in the future.”

Mufarrej added in a statement on Gemini’s website that it was “the first of this complex surgery in Latin America,” praising the work of Jeelani and the rest of the team.

“Since the boys’ parents 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 in the hospital. . We are delighted that the surgery went so smoothly and that the boys and their families had such a life-changing outcome.”

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