Three-year-old twins Arthur and Bernardo Lima held hands and looked each other in the eye for first time recently, thanks to a global team of surgeons who used the virtual world to change lives in the real one.

The brothers were born craniopagus, meaning their skulls were fused and their brains intertwined. In 90 percent of such cases, the patients will not live past the age of 10. Their parents, determined to beat the odds, traveled with their boys from their home in northern Brazil to Rio de Janeiro seeking help. Separating conjoined twins is always complicated … and this situation was even more so by factors like the boys’ age, shared vital veins and scar tissue left over from past attempts at separating them. At that time, no craniopagus twins at their age had been successfully separated.

From The Washington Post:

Medical experts had called the surgery to separate the brothers impossible.

But medical staff from Rio’s Instituto Estadual do Cèrebro Paulo Niemeyer worked with London-based surgeon Noor ul Owase Jeelani of Great Ormond Street Hospital to use advanced virtual reality technology to rehearse the painstaking procedure.

The teams knew there was no room for error. They compiled detailed 3D models of the twins’ brains using data from CT, MRI scans and other data, and reconstructed them in virtual reality.  Now with a virtual copies of the twins, the teams could see inside their heads and collaborate despite the long distance to carefully devise the complex, multi-step process that would be required. They spent months working to prepare for the procedures, trialing surgical techniques safely in VR with simulated results that kept the twins safe while their care team built skills and confidence to proceed with the surgery.

Separating the twins required seven surgeries. The final procedure alone involved more than 27 hours of operating time and almost 100 medical staff, including surgeons in separate countries wearing headsets and operating in a virtual reality room, the BBC reported.

From the BBC:

Speaking about the VR aspect of the surgery Mr Jeelani told the PA news agency: “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.

“You can imagine how reassuring that is for the surgeons. In some ways, these operations are considered the hardest of our time, and to do it in virtual reality was just man-on-Mars stuff.”

Surgeons in headsets operating on two different continents may sound like Space Age stuff, but the use of VR in healthcare isn’t just the wave of the future. It’s happening now … and building momentum.

The Washington Post reported this was the first surgery of its kind in Latin America, but the Brazilian hospital would continue to work with Gemini Untwined, the British charity that facilitated the surgery, to help other conjoined twins in South America.  

Previously at Great Ormond Street Hospital, the cardiovascular engineering team developed the 3D CARE project to design virtual reality tools that would allow clinical teams to review patients’ hearts within realistic 3D models prior to surgery.

The team used know-how from the aerospace industry where virtual reality is routinely used to train pilots by experiencing realistic flight situations, so their brain will immediately recognize the real ones. Similarly, the 3D CARE app was used to enhance the education of medical students and young doctors, and to improve communications with patients and their families. But 3D CARE’s ambition was greater, to replicate complex patient situations and allow surgeons to simulate cardiovascular procedures before entering surgical theater.

Dassault Systèmes shares their ambition and is working with research organizations and healthcare providers around the globe to develop these virtual twin technologies for the heart, brain, lung, skin and, eventually, the entire human body. 3D CARE’s founder, Dr. Claudio Capelli serves on the advisory board for a joint FDA-Dassault Systèmes project to use virtual twins of the heart to replace patients in what is called and in silico clinical trial. By connecting experts across multiple disciplines, many therapeutic areas are already demonstrating major innovations, with patients and their families benefitting from unique and unprecedented treatments.

As the case of the Lima twins has shown, safely simulating surgeries is a VR dream that’s become a reality.

WATCH: The Living Heart Project’s Dr. Steve Levine explains virtual twins of the human body at CES 2022

LEARN MORE

• Meet the clinician creating virtual models of patients’ hearts to enable personalized care
• Check out how Dassault Systémes is enabling precision medicine
• Read about Virtual Humans – Clinical Care is ripe for transformation
• Explore the Living Heart Project
• Find out how EPINOV’s ‘Living Brain’ will improve epilepsy surgery management  
• Download the 3DS whitepaper on virtual twins of humans as the next horizon in healthcare