Two twin boys, Arthur and Bernardo, were born craniopagus [joined at the brain] in Brazil, receiving support from the Instituto Estadual de Cérebro Paulo Niemeyer hospital.

The separation of the boys posed a challenge as the boys shared vital veins in the brain, and as the oldest craniopagus twins to be separated this posed additional problems. Previous attempts to separate the twins had resulted in complication to the boys’ anatomy caused by scar tissue.

To ensure a successful separation operation, the medical team in Brazil shared expertise with Gemini Untwined in the UK, a charity dedicated to the research and treatment of craniopagus twins across the globe.

The surgery team underwent months of preparation and a trial surgery conducted cross-continentally through virtual reality. Techniques were trialled that included VR projections of the twins based on CT and MRI scans.

The procedures involved nearly 100 medical staff and seven separate surgeries, with the successful operation requiring more than 33 hours operating time in the final two surgeries alone.

The video below contains scenes that some viewers may find distressing. 

Speaking to the PA news agency, Noor ul Owase Jeelani, surgeon and founder of Gemini Untwined, said that the separation marks the first time that surgeons in separate countries have worn headsets and operated in the same ‘virtual reality room’ together.

Jeelani commented: "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."

“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.”