Surgeons use virtual reality to separate Siamese twins

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Surgeons have just successfully performed an extraordinary operation: separating Siamese twins associated with the birth of the head and brain. One of the keys to this success lies in virtual reality.

“In a sense, these surgeries are considered the most complex of our time, and performing them in virtual reality was really a ‘space age thing’,” surgeon Noor ul Owase Jilani told the British news agency PA Media, which published an article about it. The information was also transmitted by the BBC. At nearly four years old, Arthur and Bernardo are the oldest craniopagus (connected at the head) twins to have been separated.

Siamese twins are born in one in 60,000 births, according to Gemini Untwined, a charity dedicated to the topic. Of these 1/60,000, only 5 are craniopagus. There are also many who survive only a very short time after birth. Suffice it to say that surgeons are faced with a very rare case.

Such surgery, which involves connected brains, is fraught with fairly obvious dangers. The twins had already undergone several surgeries before this one, but without success. To minimize the possible risk, the medical teams this time decided to conduct various tests in virtual reality. Based on MRI and CT scans, the surgeons collaborated with engineers specializing in virtual reality. In this way, they were able to obtain a three-dimensional model of the anatomy of two children.

Full 3D modeling of the anatomy of Siamese twins.

This simulation allowed them to get a clearer picture of the situation as well as practice. Surgeons from different countries were able to gather in a virtual “operating room” and perform various tests together without any danger. “It’s just wonderful,” Nur ul Owase Jilani told PA Media, referring to the integration of virtual reality. “It’s great to see the anatomy and practice the operation before putting the kids in danger.”

After several months of preparation, the real operation lasted more than 27 hours, and involved about 100 people. The operation was performed in Rio de Janeiro under the direction of the Great Ormond Street Hospital in London. The separation was successfully completed and the twins are currently recovering in the hospital. Their blood pressure and heart rate remained very high, like all Siamese after their separation, the surgeon says, until they found each other and touched hands. Then they will have to undergo a six-month rehabilitation.

The surgeons hope that, apart from the very specific case of craniopagus, their approach may be useful in many other cases in the future. “I think the model of what we have done can and should be replicated for other extremely rare conditions,” Noor ul Owase Jilani concludes.

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