Baby Saved By Doctors Using Google Cardboard After 3D Printer Fails

It’s a parent’s worst nightmare. Doctors tell you that your baby is sick and there’s nothing they can do. Luckily though, a combination of hacks led to a happy ending for [Teegan Lexcen] and her family.

When [Cassidy and Chad Lexcen]’s twin daughters were born in August, smaller twin [Teegan] was clearly in trouble. Diagnostics at the Minnesota hospital confirmed that she had been born with only one lung and half a heart. [Teegan]’s parents went home and prepared for the inevitable, but after two months, she was still alive. [Cassidy and Chad] started looking for second opinions, and after a few false starts, [Teegan]’s scans ended up at Miami’s Nicklaus Children’s Hospital, where the cardiac team looked them over. They ordered a 3D print of the scans to help visualize possible surgical fixes, but the 3D printer broke.

Not giving up, they threw [Teegan]’s scans into Sketchfab, slapped an iPhone into a Google Cardboard that one of the docs had been playing with in his office, and were able to see a surgical solution to [Teegan]’s problem. Not only was Cardboard able to make up for the wonky 3D printer, it was able to surpass it – the 3D print would only have been the of the heart, while the VR images showed the heart in the context of the rest of the thoracic cavity.[Dr. Redmond Burke] and his team were able to fix [Teegan]’s heart in early December, and she should be able to go home in a few weeks to join her sister [Riley] and make a complete recovery.

We love the effect that creative use of technology can have on our lives. We’ve already seen a husband using the same Sketchfab tool to find a neurologist that remove his wife’s brain tumor. Now this is a great example of doctors doing what it takes to better leverage the data at their disposal to make important decisions.

64 thoughts on “Baby Saved By Doctors Using Google Cardboard After 3D Printer Fails

  1. Seems strange that one printer breaking would hold up a serious medical solution. Can’t they just order on from protolabs or something? When comparing to surgical costs, ~ $300 dollars for a print seems affordable.

    1. In my limited experience the printers are usually not owned by the hospital but are managed by a research institute or uni, so just fixing it becomes difficult.

      And spending money outside the organisation structure? Impossible from a beuraucracy point of view, no matter how trivial.

    2. I can see what your saying but it seems one of the docs knew there might be a way around the issue and decided to give it a try. It worked and now by the looks of things it may be adopted as a better way to do things.

      1. Relative distances between objects in a way the brain can quickly and reliably comprehend. Model reviews are hard on a screen. I do them regularly. Some people can’t visualise things in 3D, don’t cope with the perspective not being perfect and just generally can’t extract a sense of scale without being able to see something in 3D.

        1. Such people generally fail the training to become surgeons, because even simple things like wearing eyeglasses distorts your perspective, and if people have that much trouble with perspective inconsistencies then they’ll have pretty awful hand-eye coordination in general.

          1. +1, although surgical planning can be helped as we are not always able to show appropriate 2D planes

            E.G. If the pathway to the area of interest is curved, or out of plane with anatomical landmarks

          2. Possibly. But the 3D view apparently made this surgeon even better. We spend all day seeing things in 3D and extrapolating data from that, using 2D plans requires imagination, which isn’t as advanced, mathematically, as our 3D perception system is. We’re just better in 3D, big chunks of brain and plenty of evolution saw to that.

            3D imaging is popping up here and there in medicine, and there must be an advantage or else doctors wouldn’t bother. It’s another advance, makes surgery more successful and allows surgery that would’ve been considered impossible before.

            Hooray for technology, and cardboard!

      2. Probably nothing. That’s the joke.

        History is always told by the victors. If they hadn’t had the google cardboard, they would have viewed the models on a regular screen and done the surgery anyways – but since new technology was available and was used, the story is told as if the new technology was essential to the process.

        1. This is true. It is quite fortunate that they were able to help the girl recover from her dire situation – but if she hadn’t, we wouldn’t be reading this article.

        2. You can do surgery with a stone knife or a carbolic acid sprayer, but advances make it better. I can’t say I, and presumably you, know the practical experience of performing surgery. But I understand things I see all the time, and 3D can make that better.

          Might be that the 3D gave the surgeon a better understanding of the baby’s anatomy, and led him to not make a mistake, or a less optimal procedure, than he would have otherwise. So it might have made a success of an operation they otherwise wouldn’t have risked, or that might have failed. So it might well have saved the child’s life.

          ANYTHING can be crucial to surgery. It’s a high-risk thing, with no second chances. Anything might be the thing that pushes it over the borderline into success. In fact it’s probably a mixture of everything together, every contribution helps.

          Of course without a control group of 50 babies they cut into without it, we can’t actually say conclusively. But there’s no cause to rubbish this technology.

      3. Not a doctor, but a software engineer who develops 3D games and simulations for ordinary devices as well as AR/VR devices. The short answer to your question is: A hell of a lot.

      4. Think of it like the difference between running native code on a CPU as opposed to emulating a different processor on that CPU. The brain runs natively on 3D optical data. You can do 2D, but it is slower and cannot use native libraries.

    3. It’s more of a case of “would have done it anyways the old fashioned way” – but since 3D imaging was available by coincindence, it was used, and then the story was made up afterwards.

      1. How do you know? There’s plenty of operations surgeons don’t do because the risk of failure is too high.

        You also don’t know if the op would have failed without the 3D imaging. Surgery isn’t frivolous. The story was “reported” afterward. It actually happened, in that order, for those reasons.

    4. Seems strange that they pointlessly run up medical cost with something as stupid as a #d print when a display will do just fine.
      Oh wait, pointlessly running cost is what it’s all about, so not strange after all.
      Excuse the confusion.

      1. —> Troll food <—

        Here's your noms. Believe it or not, the vast majority of doctors in the world (even in the US) are paid significantly less than they would be if they'd ploughed a simile amount of time into almost any other career.

        I suppose you believe doctors willingly put their patients at unacceptable risk or through experimental therapies every day. Truth is; they do. But by and large, that drive is actually from patients and administrators to do more, better, faster safer.

        Remember, this child had already been turned down for surgery, with second and third opinions sought. It was _not_ the doctors pushing this.

        You obviously don't understand the subtleties involved in this sort of decision, so I'll let that pass. But quite frankly the statement above belies the kind of opinions that bring to mind anti-vaxxors, "natural" therapies in a pill and fake moon landings

          1. Oh, absolutely. Turns out, you don’t need a tin foil hat, you just need an internet connection.
            As always, it’s about technical specialties getting pared down to the minimum of digestible content.

            Trying to convey the subtleties to people outside similar fields, is like me reading a year 10 textbook on astronomy, then saying “But surely they could just do very-long-baseline-interferometry by coupling Software Defined Radios, GPS units and thousands of volunteers” and then having to watch me extrapolating that to “So we’re only building more big arrays to keep academics in work, and we all know their salaries are basically paid for by the engineering firms anyway”

  2. Stupid makerbot. Did they level the build plate? Try some Kapton? Use some aquanet? Replace the steppers? Belts? Geez. What do you expect? This to work out of the box?

      1. “Real” 3d Printers are an entirely different experience from hobbyist machines.. IMO there is still not a real ‘consumer grade 3d printer’..

        The $2750 ultimaker 2 my lab bought has most of the same problems of the $400 mikrocenter knock off I have at home… Is made out of the cheapest chinese motion control parts in the world, and relies on pruned, barely-adequate open source software to do the slicing…

        1. The hospital mentioned in this article uses the Stratasys Objet500 Connex3 3D Printer. The suggested retail price is $330,000 USD I hope at this price it outperforms your $400 USD printer

          1. Yes. I know. I have ordered\used dozens of objet parts.. Very nice parts!

            I was saying our $2500 machin STILL isnt useful as a ‘consumer 3d printer’. Implying professional equipment is a different story.

            The cheapest objet machines cost around $20K now, plus some 10K of ancillary equipment. Still expensive, but a huge drop from object machines 10 years ago.

  3. Best of luck to young Teegan.
    Details are important, and not available for reasonable privacy reasons, but it should be noted that hypoplastic left heart syndrome (HLHS) has a fairly poor prognosis and surgery is palliative, not curative. The greatest struggle will come not with her heart but the interplay between heart and lung over the next few years.

    Basically the “usual” pathway of surgeries (note; multiple, rarely less than 3) is
    1) secure the shunt from right heart to the body, and reconstruct the aortic arch. After this, the right heart pumps to the body, and a small fabric tube send some of that blood to the lungs. Baby is “blue” at this point
    After about 4 months of age, if the baby grows the amount of blood going to the lungs tends to become insufficient, and the right heart is volume overloaded. The heart tends to fail after a few years (at most) if left this way. The mortality between this point and the next is up to 30% regardless, even without comorbidities.

    2) redirect venous blood flow directly to the lungs. The blood from the top half of the body (the majority of blood flow in infants) goes from vein to artery without a pump. This means the pressure going to the lungs is “passive” although driven by respiration.
    If the pressure gets too high (usually because the lungs are high resistance due to comorbidities, or failure of the heart causing back pressure) then the lungs become “boggy” and the brain, body become poorly perfused.
    This will be difficult for Teegan as she has only one lung, and the resistance will probably be borderline at best. That means such infants may get progressively worse with time and be at unacceptably high risk for going forward.
    At this stage infants and toddlers are still “blue” but the heart has less extra volume to pump around.

    3) over several years, children start having proportionally more blood going to the lower body compared to the top; they become bluer, particularly with exercise. There are other, less common complications that may also require connection of the liver and lower body veins to the lungs
    These Lower-body veins are routed to the lung arteries through a long fabric tube or tunnel. The resulting circulation of heart-body-lung is known as a “Fontan” circulation, and although there are many variants on the path to getting there, the two keys to good prognosis are low resistance through the lungs and good function of the heart.
    If the pressure/lung resistance is too high after the second stage, conversion to a Fontan is deadly and usually immediately unsuccessful. Not enough blood can get through the lungs, and that means little or no blood coming back to the heart to give you a blood pressure. In that case a new shunt is sometimes performed, but there is rarely a way forward.

    After the Fontan is complete, the heart still progressively fails. Some children will survive into young adulthood, albeit with significant symptoms. Children and young adults may be listed for heart transplant, although in many countries the lack of donors limits the success of this strategy (particularly if the child is small, as size dictates organ acceptability).
    If the lungs are at high resistance, a “heart-lung block” transplant may be considered. As this potentially means treating one patient instead of two, this is rarely an option.
    If transplantation is successful, the patient now has a different terminal disease (transplanted organ) and is not cured.

    Teegan and her family have a long journey to go, and the absence of a lung will make it significantly riskier than other children with HLHS. Given that it is a disease with such high treatment burden and relatively limited outcome, many jurisdictions would only offer “comfort care” much like it seems she was offered.

    I wish them and her treating team all the best.

    1. Patients like this child would be good candidates for artificially grown organs, made using the patient’s own cells so no rejection problems. (When or if they are ever perfected.)

      Missing a lung, looks like a reason to develop a self contained, battery powered, induction charged version of the AB-180 LVAD (now called the TandemHeart Pump). Pack it into the space left vacant by the never there lung. The first life saved by the AB-180 was Julie Mills in the UK in 1989. She contracted a virus that attacked her heart. Surgeons were able to implant the pump just in time to save her. After six days her heart had recovered and the pump was removed. She was only the 4th person to have the AB-180 and the first to survive. Previously, it had only been allowed to be tried on terminal cases whose hearts were so far gone only a transplant would have possibly saved them.

      http://news.bbc.co.uk/2/hi/health/206667.stm

      The manufacturer now claims over 3,000 lives saved with their pump.

      1. We do have such a device; in addition to external pumps (The “Berlin Heart” is one of the most commonly used ones in children) there are devices such as the “Heartware” which is, indeed, an implantable, induction-charged pump.

        There are a couple of problems, unfortunately.

        The first and most obvious is size; there’s just not that much size in an infant to fit the pump.

        The next issue is that of destination; these devices are not satisfactory final, curative or ‘destination’ therapies. They may give you time, but they give you clots, strokes, and subnormal performance. There is experience using them for (up to) years in adults as palliative, destination care but in paediatrics such experience is more limited. Think weeks for a bridge to recovery (such as viral cardiomyopathy, as in the case you suggested) or several months as a bridge to transplant.

        Additionally, the anatomy here is important. Quite frankly, you need somewhere to put the pump and tubing; and the arteries have already had the once-over by the surgeons in hypoplastic hearts (or the lungs have been skewed by the physiology, or both). In HLHS there is a whole chamber missing (which is usually used and quite essential as part of the artificial pump circuit) and just “putting a pump in” doesn’t address these connection and vascular resistance issues. Put simply, the plumbing and physiology is difficult.

        Basically in paediatrics, the main indication for artificial hearts is cardiomyopathy (diseased heart muscle – from genes, viruses or the unknown) and even then the most widespread use is as a bridge to heart transplant.

        There are serious issues with this strategy, though. Once one of these devices goes in (particularly the fully internal one) they basically can’t come out, and you damage the underlying muscle; sometimes you can replace them, and in some cases they can be removed if the heart is normally structured and recovers it’s strength, but not usually. They don’t last forever,generally keep you in bed in hospital with heavily thinned blood (think thin enough to cause brain and gut bleeds, and prevent normally rough play), compromised immune systems, attached to a machine the size of a small shopping trolley by hoses the size and stiffness of garden hose pipe(at least for the berlin heart) all the while accumulating comorbidity.

        And as the rate of organ donation hasn’t necessarily changed since the introduction of these artificial hearts, it instead comes a hurdle that potentially prolongs suffering an additional or 12 months without actually increasing the longer (1 or 5-year) survival – particularly if you end up transplanting sicker children because of the above complications. The que just got longer, but the nightclub still only lets in the same number of patrons.

        That’s if there’s even enough organs available for your indication o be listable – in some jurisdictions the number of organs is so limited that children with anatomical abnormalities are completely excluded (and reasonably if unfairly so, because of age, comorbidities, higher complication rates and complexity of the surgery compared to the cardiomyopathies)

        Put simply, the devices you suggest exist, but are not a panacea.
        Organ donations are still felt to be better (particularly for quality of life) but are not panacea.

        It’s all quite complicated and generally sad – go look up modern transplant waiting list figures in your jurisdiction to work out how sad – and the main thing you can do is discuss organ donation with your family, friends and loved ones while they are healthy, Include consideration of organ donation as part of the normal grieving of dying loved ones, consider withdrawal of care rather than persisting at all costs, and you will have done your share to help these children.

        Donating money to support and research organisations is also nice.*

        *Not affiliated with manufacturers or such organisations, but I work on the medical side

    1. Because it’s complicated, unusual, and changing the approach might improve survivability (especially sternotomy versus clamshell) so especially whe offering a second or third opinion, you use all information available to you?

    2. Making 3D prints to help plan surgeries has been going on since at least the early 90s. The first time I heard of 3D printing was when my grandfather took me to a engineering firm developing a heart valve he designed – in their labs they had a SLA machine making a full size human skull with a big hole in it.

      Still, the narrative above is a bit…. Someone knows how to get attention on the internet, it appears to me… Could be wrong.

    3. It may have been a uniquely complicated case – or, more likely I think, the surgeons wanted to use a new variation on the proceedure. In either case, it pays to literally look at the problem from all the angles.

      1. Given that this is a birth defect, I’m guessing there’s no “standard” way the heart would grow, and at least some of the complications in surgery come from having to work out what unusual features there are while doing the surgery. And while a 3D image can help, I suspect an actual object makes it much easier for the kind of problem solving this would involve. VR is good, but not perfect, and in this case any kind of distortion that might occur due to a mis-configured headset or something would cause a lot of problems which a physical print wouldn’t have

  4. Good story, even if the exact narrative seems a bit…. Designed to get attention, maybe?

    Like another poster asked, what can possibly be seen on google cardboard that couldnt be seen on a regular monitor. I think they knew what they were going to do before the 3D print failed, or the google cardboard was involved. I could, of course, be totally wrong, and the semi-coherant 600×700 stereovision was better than a good workstation monitor?

        1. People occasionally die from elective surgery, they’re warned about that in advance and make an informed decision. That’s how things work. You weigh up the risks and rewards. That’s how LIFE works!

      1. What experience do you have in surgery in general? What experience do you have in visualization techniques as applied to medical science?

        And your idea of just letting someone die if surgery could save them (at least for a few years – hopefully long enough for new techniques to be developed) isn’t just cynical – it’s bordering on psychopathic.

        1. So instead you go in with only a thin thread of understanding on what you’re attempting, and kill the patient on the table, just so you can say you tried to do something?

          I think -that- would be bordering on the psychopathic, or at least the irrational.

          “Practice two things in your dealings with disease: either help or do not harm the patient”

          1. Is that the Hippocratic Oath? Hippocrates didn’t have 3D visualisation available to him.

            In real life it isn’t a choice of “do not harm”, when there’s already harm, which you MIGHT be able to reduce, or you might make worse. You can’t always know until you open up the patient. No, I’m not a surgeon, but this isn’t bloody rocket science.

            You use the best knowledge you have available, and the greatest skill. Then, with the best idea you have of how things might turn out, you ask the patient / parents. They decide on an op that might kill the patient before they die anyway, or might extend their life. Doing nothing generally gives you something in between, where they die a little while after.

            There is no “do nothing” option. Doing nothing lets the patient die anyway. These are grown-up decisions, not “Morality with the Mr Men”.

            This is all fairly well-known stuff. A daytime soap could give you the basic idea of the principle.

          2. Real doctors dont have the luxury to “do no harm”. The hippocratic oath is MooPoo.
            Everything carries a risk of harm. Doing nothing causes risk, doing something causes risk, and even turning up to the doctor changes this multidimensional matrix or risk, harm, and outcome.

            Let’s take going to the GP for a toothache. The following could happen;
            – You could be in a car crash on the way to the GP because of your ache reducing concentration
            – You could be in a car crash on the way home because of the sedating analgesics
            – You could become addicted to the opioid or non-opioid analgesics
            – or have a complication from them causing one of liver toxicity, renal failure, seritonin syndrome with malignant hyperthermia
            – You could be falsely reassured by the GP that it would pass with analgesia, which would be reasonable, except you instead get a;
            – infected tooth root which could have been prevented with antibiotics
            – cerebral abscess which could have been masked with antibiotics, making you more lily to present late
            – quinsy, causing breathing obstruction
            – You get an oral antibiotic (usually a penicillin derivative because it’s generally the best for oral bugs, and
            – you have a resistant organism, an it doesn’t work. See above outcomes
            – you have an immediate anaphylactic reaction, which you don’ survive, having never had one before
            – it doesn’t work because it’s invade
            – You get given an intramucular antibiotic, the GP keeps you in the practice for 1/2 hour to try and ensure there is no adverse reaction which may reduce the invasive complications from above, however
            – 1 hour later you get anaphylaxis
            – on the follow-up oral dose you get anaphylaxis
            – you get a painful haematoma where the injection was
            – you get a necrotising fibroma where the injection was
            – You lose the bike race the following weekend because of your painful buttock / arm, meaning your amateur career is essentially over
            – you get an infection of a resistant organism where the injection was
            – you get an embolus from the injection or complication to your lungs, which cause you to need hospital admission
            – There s an interaction with an existing medication which is rarely document and generally accepted, but throws your other conditions out of whack
            – You are given a second-line agent because of a history of “rash” when given oral antibiotics as a child for a fever
            – And you are allergic to the second line a get anyway, because some allergies work like that
            – and it does’t work; it’s second line for a reason, and the first line would have worked
            – and you develop a resistant organism, because that’s part of how it happens, meaning you are in hospital or several months
            and you foot the bill because the insurance doesn’t cover it
            – Whatever the treatment plan, it works as planned, and the pain gradually resolves over about a week.
            – your employer fires you because of the sick leave (you were on casual employment / worked there for less than a year so no unfair dismissal)
            – your insurance doesn’t cover the visit and medication because it wasn’t an “emergency”
            – you are such a poop to be around that your marriage / de facto relationship breaks down
            – you continue getting similar tooth infections every few months, because this is all just a stopgap, and the issue s that your teeth are screwed from a lack of dental care
            – Your GP refers you immediately to dentist to treat the underlying issue;
            – But your insurance doesn’t cover it
            – They are busy, and you fail to wait (because the painkillers work, so it seems less important)
            – There is no appointment for three weeks
            – Thee are no public dental or emergency dental services, because they have been defunded / are only for children / etc
            – The dentist counsels for an extraction, and you have that done in their rooms, however
            – You have a mild bleeding disorder which means you bleed like a pig and are admitted to hospital for a blood transfusion
            – You don’t communicate clearly (possibly because of the analgesia) and tell the dentist that the wrong tooth s hurting; they pull that out as it, too looks like it is infected (it is, just less so) and leave the problematic one behind
            – you have a reaction to the general anaesthetic / sedative they give you, and although they resuscitate you well enough you’re in hospital for a week
            – the local anaesthetic is accidentally (i.e. all appropriate procedures followed but happens nonetheless) injected into a small vein, causing either seizures or a venous thrombus and brain damage
            – or a cardiac arrhythmia
            – You test positive for opioids at your next sports event, and because you didn’t discuss it with the GP it is ruled inappropriate use; you are banned from sport for 2 years ending your amateur career, as well as your College scholarship

            So tell me, what would you do? Because I know what would (and do).
            I would review all the evidence, in whatever ways I could, minimise further harm and unessecary investigations where possible and “safe”, and discuss treatment options, risks and effects with the patient in a mature and reasoned way, accepting fallibility but trusting in the shared experience of the profession.

            And I do harm. But I also do good. And I know that it’s not a balance, it’s a batter that takes time and knowledge and a retrospective viewpoint to try the cake and work out if you got the recipe right.

          3. [AussieLauren] I’m not a doctor but I’d prescribe you 2 fifths of Bicardi 151 proof and a pair of adjustable pliers. Yank those teeth out! First order is to take a culture and find out WHAT you got (gram neg or positive). 2nd order is to get you to stop drinking coke and rinse with H2O2. Quit using the same toothpicks. Floss. Etc.etc.etc.

          4. @[JohnScnow]
            I’ll take the rum (though I prefer Bundaberg). Always looking for pliers, always loosing that one pair that lets me adjust the 3D printer when I’m printing organs (from plastic, unfortunately).

            BTW, Absolutely agree with you – the harm in my example started long before seeing the doctor, and the cure lasts long afterwards. I suppose my point is that life’s miracle isn’t so much that it exists, so much as that it goes right so much of the time anyway. Modern medicine is hindered by the number of ways we KNOW things can go wrong, and the Inherrent UNKNOWNs in diagnosis, intervention, and the like.

            And yes, I’ve seen many people have minor or major complications from having a blood culture taken. Imperfect tests, 60% sensitivity and all that Jazz, so even that isn’t flawless.

  5. maybe the VR aspect of the 3D representation is what works better. Place the organs in the position that would be presented when on the table, then maneuver as if working on them in that position.

    With many thousands of surgeons in the world there’s going to be NO RIGHT WAY to present the information they need to perform surgery. There need to be alternatives and choices. Some people can do electronics in their head, others need to sit down with a schematic and begin…

    Add to that the fact that no person on this planet with the exception of an identical twin is like any other. Planning ahead for a complex surgery on a patient and going into it prepared for what you find is important. Should also be noted that it’s very time sensitive. You can’t look at a scan from 3 years ago and expect what you’ll see to be as it was. It might be, but depending on the condition you’re treating the structures could be radically different.

    1. It is kinda good PR, but I assume it actually happened. Any 3D technology would have done, doesn’t have to be an Apple phone. That’s what I took from the story.

      It’s not like Apple are going to make a lot of sales to hospitals out of this. Overall it’s the surgeons and associated medics who are the heroes in this.

  6. One lung, and half a heart, and we’re celebrating that this baby survived? For what, an extremely marginal life that will take a toll not only on her but her family and anyone she becomes involved with? People need to think these things through a little more.

    1. Er, the alternative was she’d die. They didn’t take half her heart and a lung out or anything. How’d you feel if it was your kid? Well then. Hopefully well then, at least, dunno your attitude to defective kids with inefficient cardiopulmonary systems.

      I’m developing Benchoff’s Syndrome. WTF is wrong with some people here?

        1. Maybe it’s infectious? I would have thought you’d developed tolerance by now. Doesn’t saying it’s a disorder imply there’s a known causation, rather than a constellation of symptoms?

          I apologise for some of my pontification on these things, I am _trying_ to be sensitive to the family while being forthright with opinion, understanding and knowledge (in about that order). I for one welcome my future diagnosis of Benchoff Disease* even if it would be named some stupid acronym given modern naming conventions.

          *smirk

          1. As ever, it’s nice to hear from the experts, nice to have a medic (surgeon?) to give the real details.

            Not on Benchoff’s Syndrome (it’s definitely a syndrome), the other stuff.

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