A pair of Brazilian twins with fused brains have become the oldest children in the world with the condition to be successfully separated, with the help of virtual reality.
The family of three-year-olds Bernardo and Arthur Lima were originally told that surgery would not be possible, but UK charity Gemini Untwined later funded a team to perform the operation.
In the months before the procedure, surgeons in London and Rio de Janeiro were able to practice techniques together in virtual reality, using images of the twins based on CT and MRI scans.
Dr Noor ul Owase Jeelani, the neurosurgeon who founded Gemini Untwined, said: “It’s just wonderful, it’s really great to see the anatomy and do the surgery before you actually put the children at any risk”.
He added: “You can imagine how reassuring that is for the surgeons. In some ways, these operations are considered the hardest of our time”.
The separation consisted of seven surgeries, with the final operation taking 27 hours and involving nearly 100 medical staff.
Bernardo and Arthur are reported to be recovering well, and four days after the last operation they were able to touch hands for the first time.
Of the estimated 50 pairs of twins born with the condition each year, it is thought that only 15 live beyond 30 days.
The surgical team said they were hopeful the twins would now have an average life expectancy.
In 2017, an American couple who rejected pressure from medics to abort their conjoined twins spoke of their delight in the decision they made.
Doctors did not believe Callie and Carter Torres would survive past the eleventh week of pregnancy, but they were born by caesarean section at 37 weeks.
Mum Chelsea spoke to the Daily Mail after she and her husband Nick chose life for the twins, saying they were “very excited” to have the girls.