British Asian paediatric neurosurgeon separates Brazilian conjoined twins with fused brains

A British Asian paediatric neurosurgeon led complex surgeries to separate Brazilian twins conjoined in the head.

Nearly four-year-old Bernardo and Arthur, born with their heads fused, are the oldest twins to undergo such a procedure whose success is considered a “remarkable achievement.”

Noor ul Owase Jeelani, who works at the UK’s Great Ormond Street Hospital, guided a team of about 100 medical staff that conducted the procedure in Rio de Janeiro after months of preparations using virtual reality.

The process involved seven surgeries and with the final two taking more than 33 hours of operating time at the Instituto Estadual do Cérebro Paulo Niemeyer.

Jeelani said that with the success of the process, the local team in Brazil was equipped with the capabilities and confidence to undertake similar works in the future.

“It is through this process of teamwork and knowledge-sharing globally that we can hope to improve the outcome for all children and families that find themselves in this difficult position,” the Kashmir-born expert said.

“This is only possible through generous donations from members of the public,” the doctor said referring to Gemini Untwined, which is involved in raising funds for siblings born joined at the head.

The separation was particularly challenging as the craniopagus twins shared vital veins in the brain.

Born in northern Brazil in 2018, Arthur and Bernardo were cared for by the institute for two and a half years.

Some doctors felt their separation was impossible till Jeelani and his team were contacted earlier this year for advice.

For preparations, the experts created virtual models of the anatomies of the two-year-old craniopagus sisters who were separated in Pakistan in 2019.

The head of surgery at Instituto Estadual do Cerebro Paulo Niemeyer, Gabriel Mufarrej, said, “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 had become part of our family here in the hospital”.

“We are delighted that the surgery went so well and the boys and their family have had such a life-changing outcome,” the doctor said.