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Conjoined twins separated with VR surgery

August 3, 2022

Surgeons have successfully separated twin boys fused at the brain with the help of virtual reality (VR) technology.

Surgeons have successfully separated twin boys fused at the brain with the help of virtual reality (VR) technology. Conjoined.

Three-year-old twins Bernardo and Arthur Lima underwent surgeries in Rio de Janeiro, Brazil, with medical direction from London’s Great Ormond Street Hospital.

Medical teams spent months trialling surgery techniques, using virtual reality projections of the twins based on CT and MRI scans. Surgeons in separate countries then wore VR headsets to operate together in the same ‘virtual reality room.’

The boys underwent seven surgical interventions, with the final operation taking almost 100 medical staff 27 hours to complete.

The charity which funded the operation, Gemini Untwined, described it as one of the most complex separation processes ever completed. Conjoined twins account for approximately one in 60,000 live births, and craniopagus twins – or twins joined at the brain – have a particularly low survival rate.

Previous attempts to separate the boys had left them with significant scar tissue. Their anatomy was also complicated by their advanced age, and the fact that they shared vital veins in the brain.

Paediatric neurosurgeon Noor ul Owase Jeelani, who was involved in the procedure, said the operation’s use of VR technology helped to alleviate these problems: “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.”

The boys’ blood pressure and heart rates were ‘through the roof’ following the operation – but their vital signs stabilised as soon as they were reunited and touched hands. They will now undergo six months of rehabilitation.

Dr Gabriel Mufarrej, head of paediatric surgery at Instituto Estadual do Cérebro Paulo Niemeyer in Rio de Janeiro, led the surgery alongside Mr Jeelani. Dr Mufarrej said the surgery would be ‘life-changing’ for the twins.

Hospitals and care settings across the UK are already using VR as a non-drug way to treat patients, as an alternative to general anaesthetics and to treat chronic pain. It is hoped that the surgery’s success will pave the way for further use of VR techniques in complex surgeries.

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