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Graham Offer, Consultant plastic surgeon at Leicester’s Hospitals, is a leading specialist in Complex abdominal wall reconstruction. His work focusses on cases where a large defect or hole in the abdominal wall occurs which the patient’s bowels then move through and push out under the skin. In some cases where the hole is very large a giant hernia develops. He and his team have been developing techniques to enable the largest of these hernias to be closed.
Hernias often range between 3 and 4cm across. With the new technique, the team can now operate on giant hernias which can develop to be 20 to 30 cm across, meaning they are up to 10 times the regular size.
The new procedure that is used is a form of ‘component separation’. The team combine three techniques, including a TAR Posterior Release with an Anterior Release and also a Rectus Sheath Release. In effect, they split the muscle layers of the abdomen and move them over each other. Imagine a sandwich, with three layers. They split the layers and push them to the sides. So the sandwich covers a larger area of the plate (but is thinner). They have closed 19 patients’ giant hernias so far.
Glenn Williams, 67, from Leicester, is one of Mr Offer’s patients and had one of the largest abdominal hernias that has ever been successfully closed in Leicester and one of the largest ever seen by the team with a c.20cm by 30cm defect. After two years of having the hernia, he met with Kirsten Boyle, Consultant surgeon at Leicester’s Hospitals, who informed him that Mr Offer and the team could operate on his hernia. This took place successfully.
Glenn said: “My life when I had the hernia made me quite depressed, as it got bigger and bigger and I found I could do less and less because the weight of it. It caused me to suffer with back ache, dizzy spells, aches in legs, it was just horrible. People would stare at me where ever I went, and I could hear comments from people saying I have a football up my coat, or I've been shop lifting, or when was my baby due. It affected me not only mentally, and physically, but emotionally too.
“When Mrs Boyle told me I could get some form of life back I had a spring in my step. My life became a kind of whirlwind, I had got the best news I'd heard in a long time, meeting Mr Offer and listening to him explain how big the operation would be just didn't seem to sink in. And still now I've had my operation I am still surprised how big it was. I am not totally recovered and that I know will take time, but I can look at myself in the mirror now and not find my reflection repulsive. I now do things more slowly and still suffer with back ache but having a normal body, and people not staring at me when I'm out makes me feel better, and happier. With time I know I'll get stronger and able to do more and these are the days I look forward to.”
Mr Offer is delighted with the success his team have achieved for patients like Glenn: “A few years ago hernias like Glenn’s would have been inoperable. In looking to operate on bigger and bigger hernias, I brought together the three main hernia surgery techniques used in abdominal wall reconstruction and developed a method to combine them which means that we can now operate on patients who would have otherwise been told that nothing could be done.”
Mr Offer has since been asked to speak at an International Conference in India to present his technique and hopes that it will be of benefit to increasing numbers of patients.
This procedure changes lives and Mr Offer and his team would like those patients who have previously been told that nothing could be done, to ask for a GP referral to his team.
Video available at: https://vimeo.com/151133578
Pictures available on request.