Bernardo and Arthur Lima were born in 2018 in Roraima, Brazil, as craniopagus twins—fused at the crown of the skull, sharing major draining veins and, by hospital accounts, about 15 percent of brain tissue. They faced opposite directions and could not look at each other. From eight months of age they lived at the Instituto Estadual do Cérebro Paulo Niemeyer in Rio de Janeiro on a custom bed. Other experts had called total separation impossible. Neurosurgeon Gabriel Mufarrej’s team and London-based Noor ul Owase Jeelani of Great Ormond Street and the charity Gemini Untwined planned a staged campaign paid for by Brazil’s public health system.

They used CT and MRI scans to build a digital model and, for the first time in this setting, rehearsed together in a shared virtual-reality operating room while one group sat in Rio and the other in London. Jeelani called the rehearsals “space-age.” The boys underwent a series of operations—seven to nine depending on how partial and definitive stages are counted—involving nearly 100 staff. The last sessions in June 2022 lasted on the order of 13 hours and then 23 to 27 hours. Scar from earlier attempts made the anatomy harder. Both children survived. They were among the oldest twins with fused brain tissue to be separated. After months of rehabilitation they went home in late 2022 and spent Christmas with their parents, Adriely and Antonio, as two children in two beds.

Craniopagus twins are a small fraction of already rare conjoined births. Shared venous drainage is the usual reason separations fail. Virtual rehearsal does not remove that risk; it lets surgeons practice the sequence before cutting. The outcome was two living boys who can see each other’s faces—not a guarantee of identical development or an absence of further neurology. The Rio institute became a Gemini partner for future Latin American cases. That is the durable institutional result. The human one is two brothers who no longer share a skull.

Sources
Gemini Untwined case summary, “Arthur and Bernardo”; G1 and Estadão reporting from Rio (2022); Washington Post and AFP coverage of the June 2022 separation and VR planning with Jeelani and Mufarrej.