Case Study: Arthur & Bernardo


Our mission at Gemini Untwined is to empower medical teams around the world with the skills, knowledge and experience to undertake these highly complex procedures themselves.

With Arthur and Bernardo, twin boys from Brazil, we were able to do just this. Arthur and Bernardo were born craniopagus in a rural part of Northern Brazil in 2018. Their parents, Adriely and Antonio Lima, brought the boys to Rio de Janeiro where they would be diligently cared for by the dedicated medical team at the Instituto Estadual do Cérebro Paulo Niemeyer for two and a half years.

Earlier this year, the hospital in Rio contacted us for advice after they were told by other experts that the surgery to separate the boys was impossible. 

Our team, led by Mr Jeelani, spent months working with the local team in Rio to prepare for the procedure. The separation was the most challenging to date as the boys shared vital veins in the brain. At almost four years old, Arthur and Bernardo were also the oldest craniopagus twins with a fused brain to be separated, bringing added complications.

The procedures involved nearly 100 medical staff and seven separate surgeries, with over 33 hours operating time in the final two surgeries alone. However, most importantly, they were successful. 

 “As a parent myself, it is always such a special privilege to be able to improve the outcome for these children and their family,” commented Dr Jeelani. “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.”

Central to its success was the sharing of expertise between the medical team in Brazil and Gemini Untwined in the UK. The surgical team underwent months of preparation involving a trial surgery conducted cross-continentally in virtual reality, the first time such technology had been used for this purpose in Brazil. 

Following the surgery, the Instituto Estadual do Cérebro Paulo Niemeyer will now become a Gemini Global Partner hub, ensuring that similar cases in Latin America receive the same level of world class care in the future. Meanwhile, Dr Gabriel Mufarrej, Head of Paediatric Surgery at Instituto Estadual do Cérebro Paulo Niemeyer, will continue to work with Gemini Untwined to share the knowledge that his team have built up through this separation.

As for Arthur and Bernardo, the boys will soon begin their six months of rehabilitation at the hospital. With their fourth birthday approaching, they will be able to celebrate being separate – but together – for the first time, finally able to see each other face to face. 

To help other children like Arthur and Bernardo get access to life-saving treatment, please consider a donation.





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