A Consultant Vascular Radiologist in Hull has performed a world-first in keyhole surgery to save a patient with a life-threatening aneurysm.

Dr Raghu Lakshminarayan led a team including consultants, radiologists and anaesthetists along with Interventional nurses, radiographers, theatre nurses and ODPs, to save the patient by performing the world’s first fenestrated Altura graft at Hull Royal Infirmary.

With his patient, a man in his 80s, now back home after the procedure, Dr Raghu said: “My worry all the time is about the patient and how he is doing. I just wanted to see everything was right with the new device and I was relieved that it was.”

The patient developed an aneurysm – an abnormal bulge or swelling – in his aorta, the major blood vessel that carries blood from the heart to the rest of the body, around ten years ago but recovered after surgery.

However, he recently developed a second swelling close to where his previous surgery had been carried out, just below his right kidney. That previous surgery and the position of the second aneurysm meant conventional surgery was not an option this time.

Instead, Dr Raghu worked with Lombard Medical in Oxfordshire to create a special fenestrated (window) Altura graft, the first of its kind in the world, to save the man.

Normal fenestrated grafts are a single cylinder with two “windows” which the surgeon positions in front of the patient’s kidney arteries to keep them functioning. Altura grafts, on the other hand, come in two parts, without fenestrations, and have been used below the kidneys up until now.

However, Dr Raghu planned to help design windows in both grafts to create the “fenestrated Altura graft” – a two-cylinder graft with fenestrations over the kidneys – to save his patient.

Dr Raghu said: “The company had discussed this possibility with me about this time last year to see whether I would work with them. I made multiple trips there to use flow models and also tests on cadavers to see what worked well. However, Covid-19 came along and the work was paused. When this patient then came to us and I was able to put two and two together.

“It was explained to the patient that his options were not doing anything or performing the procedure with a completely new graft. If we did nothing, the aneurysm would have burst, although we couldn’t say when, and that would be life threatening.

“He was aware that what we were trying to do was a world’s first.”

Using a CT scan and 3D printing, Dr Raghu was able to evaluate the fenestrated Altura graft to his exact specifications in relation to the patient’s kidney arteries.

Surgery was then carried out by Dr Raghu and the team on the patient at Hull Royal infirmary. Working to dimensions of 6mm diameters for the windows, the whole procedure was carried out as keyhole surgery.

The team included Mr George Smith (Consultant Vascular Surgeon), Dr Vivek Shrivastava and Dr Saira Sayeed, both Consultant Vascular Radiologists, and Consultant Anaesthetist Dr Christopher Rigg,

Over four and a half hours, the graft with the two tubes to cover the aneurysm was inserted from the top of each leg with the fenestrations over the kidney arteries to allow the stent extension to be fitted from tubes inserted just below the man’s collar bone and moved into the kidney fenestration.

Dr Raghu said: “Knowing what you’re doing is the first in the world does add to the pressure during the procedure because you don’t know how the graft will behave.

“Even though you’ve practiced on flow models or cadavers before, you don’t know how it will behave in the patient or orientate itself. If you’re halfway through and the windows are at 2pm on a clock face and the patient’s kidney arteries are at 4pm, you know you’re in trouble. But it went well.”

The patient was well enough to go home after 12 days.

Dr Raghu said: “I’m very proud to have been able to perform this procedure here in Hull and be part of the evolution of grafts. This is possible only because of a fantastic team of professionals from various specialties willing to work together for the common good of the patient.”

Hull University Teaching Hospitals NHS Trust is hoping to receive more than £3m of government winter funding to help Hull Royal Infirmary and Castle Hill Hospital this winter.

Seasonal illnesses like flu among an ageing population, falls caused by bad weather and viruses like RSV and bronchiolitis among children has resulted in major pressures on beds during previous winters.

Plans for this winter are already in place with the threat of a second spike of Covid-19 and hospital services already impacted by the pressures of the pandemic.

A flu campaign involving a large-scale vaccination programme to help every member of staff avoid the flu and a plan to manage potential problems with the EU exit are also in place.

Michelle Kemp, Deputy Chief Operating Officer

Deputy Chief Operating Officer Michelle Kemp said: “We have been working for months on plans to see us through winter, regardless of a second wave or not.

“We are doing everything we can to help you or your loved one if you need us and make sure our services and our teams are in the best possible shape.

“But this isn’t just about what we’re doing – you can play a major part in this by only coming to our Emergency Department (ED) with genuine emergencies so we can help those with life-threatening and serious illnesses and injuries.

“If you do this, our hospitals will be able to manage the relentless pressure of winter and whatever else comes our way.”

The trust’s winter plan includes

• A new winter ward opening in December with 22 extra beds
• Pathology services expanded for swift diagnosis, allowing treatment to begin
• A new contact and acute referral service for GPs
• Extra nurses and porters in ED to transfer patients who need admitted onto wards
• Additional admin staff on wards to speed up discharge for patients well enough to go home
• A new at-home IV service to give antibiotics to sick children, enabling them to stay at home instead of in hospital
• Extra clinicians including consultants, specialist nurses and surgical staff
• Seven-day services in the Cardiology Unit and Cardiac Cath Lab to help patients with heart conditions

In addition, we have plans for more than £500,000 to be invested in additional clinical support services including the flu campaign, pharmacy, diagnostic services such as MRI and CT and therapies to ensure patients get access to rehabilitation and support.

Extra nurses will also be recruited to work as part of the teams at Hull Royal Infirmary and Castle Hill Hospital.

Work begins this week on the £60m transformation of Hull Royal Infirmary.

A new, three-storey entrance, an assessment unit, modern pharmacy, restaurant, shops, improved facilities for parents of sick children and a multi-faith area will be part of the major construction programme lasting two years.

Subject to both planning approval and business case approval, construction work is expected to transform the front of the tower block, a landmark building in Hull City Centre which has remained largely unchanged for more than 50 years.

Duncan Taylor, Director of Estates, Facilities and Development at Hull University Teaching Hospitals NHS Trust, said: “The aim is for us to have better use of more flexible space to deliver our services.

“Staff, visitors and patients will benefit from a fantastic facility at the front of the building with shops, a new restaurant and waiting facilities and overnight facilities for parents of children in our paediatric department.”

Wards 36, 37 and 38 have been created behind the ambulance bay for the Emergency Department with 52 additional beds in response to the pandemic.

Ward 36 opened this weekend as a 12-bed assessment facility which will be used to isolate and treat patients with confirmed or suspected cases of Covid-19, other infectious diseases and seasonal illnesses more common during winter, including flu.

The Acute Medical Unit and the Ambulatory Care Unit including the Surgical Ambulatory Care Unit have already moved temporarily to Wards 37 and 38, allowing construction work to begin on a combined unit for patients who require further assessment before admission onto a ward or discharge home.

Work on the new, much larger and self-contained assessment unit is expected to take around three months, providing better facilities for patients with views over the front gardens and natural light.

Pharmacy will move to the back of the ground floor, with a new robotic arm installed to pick prescriptions.

The “Yellow Brick Road” weaving through the gardens from Argyle Street to the main entrance will be closed off with eight-foot timber fences to protect people from the construction work over the next few weeks ahead of work on the new front entrance beginning in earnest in October.

Mr Taylor said: “There may be some inevitable disruption to allow us to carry out this major transformation but these facilities are long-awaited on this site.”

Frontline staff caring for patients with confirmed or suspected Covid-19 are being prioritised as part of a campaign this year to protect vital NHS services and patients during the pandemic.

Hull University Teaching Hospitals NHS Trust is launching a major vaccination programme to offer the flu jab to all clinical and non-clinical staff at Hull Royal Infirmary, Hull Women and Children’s Hospital, Hull Eye Hospital, the Queen’s Centre and Castle Hill Hospital.

Last year, around 83 per cent of trust staff received the flu vaccine to protect them, their families and their patients from the virus.

As the trust prepares for a potential second wave of Covid-19 over the winter months, plans are also under way to ensure as many staff as possible are vaccinated against flu, with staff working on wards with Covid-19 patients or other clinically vulnerable patients prioritised.

Chief Executive Chris Long said: “This year, more than any other year before, it is essential that as many people as possible are vaccinated against the flu.

“We know health care workers are at greater risk of catching flu because of their increased exposure to illnesses so we want to do everything possible to protect our staff from what can be a very serious illness.

“We need our people to be fit and healthy, especially this year, so they are there to look after people when they need us most. Each and every one of us also needs to do everything we can to prevent spreading the flu to our patients, who are already seriously ill.”

Around 200 vaccinators have been trained by the trust’s Occupational Health team to deliver the vaccine in every ward and clinic across all hospitals. Vaccinators will be available to offer the jab to shift workers.

Non-clinical staff will also be able to attend special, socially-distanced clinics at both Hull Royal Infirmary and Castle Hill Hospital to receive their vaccine.

Adults who are at most risk of flu are being urged to take up the offer of a free flu jab. They include includes pregnant women, those with a long-term condition like a heart problem, kidney disease, severe asthma or those with lowered immunity. People with a BMI of 40 and above, those with learning disabilities, neurological conditions, problems with spleens, diabetes or those who have had a stroke should also get a free flu vaccine.

The free jab scheme is also being extended this year to those on the NHS Shielded Patient List for Covid-19, health and social care workers employed through personal budgets to deliver domiciliary care and children aged 11 by December 31.

Later in the year, the free flu vaccine may be given to people aged 50 to 64. More information on this will become available over the next few weeks. However, if you’re aged 50 to 64 and in an at-risk group, you should not delay having your flu vaccine.

Mr Long said it was crucial that those eligible for a free flu jab took up the offer to protect the NHS this winter.

He said: “The public can help us by getting their own flu vaccine. If we all play a part in protecting ourselves, our families and our communities from the flu, it means we’ve got a better chance of ensuring hospital services can keep running even if we are hit by a second wave of Covid-19.

“Getting the flu vaccine means we’re less likely to be overwhelmed by severe cases of the flu at the same time as we’re trying to help people who may catch Covid-19 if there is a second wave.”

Jess accepts Steve’s marriage proposal

After 18 years together, the dream of becoming a family has finally come true for Jess Mayall and Steve Branson from Waltham near Grimsby, but with a special added surprise.

Shortly after giving birth to baby Imogen on Wednesday, Steve proposed to Jess with the help of midwifery staff at Hull Women and Children’s Hospital and his new baby daughter.

Dressed in a special baby-grow just minutes after being born, Imogen delivered the surprise message, “Mummy, will you marry Daddy?” and Jess’s response was instant.

Jess said:

“It was such an amazing surprise. We’ve had many ups and downs together, but we’re thrilled to be able to start the next part of our journey as a family.

Baby Imogen pops the question!

“We have been together for almost 18 years and have been trying for a baby for almost 6 years now. In 2018 we were lucky enough to conceive with the help of the IVF team in Hull but sadly, on 5^th July 2019, our daughter Ava was born sleeping at 38 weeks and 3 days.

“Imogen is our Rainbow baby; she was also conceived via IVF at Hull so it was lovely that she could be involved in this.”

Steve said:

“Now that Imogen is here it feels like a huge weight has been lifted and this just felt like the perfect time to ask Jessica to (finally) be my wife! We can finally start the next chapter of our lives with Imogen; with Ava in our hearts.

“I would like to thank everyone on the labour ward for helping me to pull this off; the care we have received has been incredible from start to finish.

Jess, Steve and baby Imogen

“We would like to express our gratitude to all of the doctors, especially Dr Tibbott who’s been amazing, the IVF team especially Dawn and Nicky, and Louise and Sarah from the bereavement team, all of whom have supported us throughout.”

Jade Barker, midwifery assistant at the hospital says:

“My colleagues and I were happy to help Steve make the proposal.

“It was so nice to be involved in something so meaningful and positive for this lovely couple after everything they have been through.”

TV cameras will join the staff and patients of Hull Royal Infirmary once again this autumn when filming begins for series 2 of “A&E After Dark”.

The programme, made by Crackit Productions, provides a ‘warts and all’ account of life in Hull’s busy emergency department, one of just a handful of major trauma centres across the country.

The first series, which was broadcast on Channel 5 during June and July, peaked at over 2 million viewers. Hospital staff praised the docu-series for providing a very real account of what it’s like to work the A&E night shift, while viewers were left full of admiration for the staff and horrified by the abusive behaviour they face on a regular basis.

Now, Crackit Productions have been given the go-ahead to film a further 10 episodes which will also reflect how the current challenges associated with COVID19 are impacting upon staff and the wider department. Filming will begin this week.

Teresa Cope, Chief Operating Officer for Hull University Teaching Hospitals NHS Trust says:

“The response to the first series of A&E After Dark was overwhelmingly positive. It provided a real insight into the clinical and emotional challenges our staff face on a daily basis, and the very unpredictable nature of their work.

“We know our staff do amazing things, but they largely happen behind the scenes, and it’s important to us that people see them.

“We want people to watch the series, to see some of the really serious and life-threatening cases that come through the doors, and to feel proud of the clinical expertise we have right here in Hull. We also want people to watch the series and reflect on their own use of A&E; do you really need to be here? Could you have been treated elsewhere? Was your behaviour towards staff appropriate?

“People were amazed just how A&E is used, and in some cases abused, in the first series, but we saw an enormous outpouring of support and appreciation for our staff. The current situation with COVID19 presents them with an additional set of challenges, so the next round of filming will really help to capture a place in time and show how, even when faced with a global pandemic, our staff still take it all in their stride and rise to the challenge.

“We’re looking forward to working with Crackit again to deliver another eye-opening series of programmes which shows just how remarkable our people really are.”

Helicopters are now able to fly critically ill and injured patients directly to Hull Royal Infirmary after its new £600,000 helipad was declared operational.

Hull University Teaching Hospitals NHS Trust has completed the major construction project so patients seriously hurt in accidents across East and North Yorkshire and parts of Lincolnshire can be flown into the hospital grounds, the Major Trauma Centre (MTC) for the area.

The helipad, behind Hull Royal Infirmary’s £12m Emergency Department (ED), had been funded entirely by the HELP Appeal, the only charity in the country dedicated to funding NHS hospital helipads.

Trust Chief Executive Chris Long said: “We are deeply grateful to the HELP Appeal for its £600,000 donation which has allowed us to construct the helipad directly behind our Emergency Department.

“There is no doubt that having a helipad so close to our highly skilled major trauma team means we will be able to save more lives in situations where every second counts.”

Robert Bertram, CEO of the HELP Appeal

Robert Bertram, Chief Executive of the HELP Appeal, said: “As the Major Trauma Centre for the whole region, funding a helipad outside ED was essential. Everyone is aware of the vital roles that hospitals and air ambulances play in treating a critically ill patient but having a helipad outside the ED can play a significant part in saving vital minutes when transporting a patient to the expert care they need to save lives.

“As the only charity in the country funding live-saving helipads, we are pleased to be able to cover the entire cost of the helipad. We know the difference having a ground-level helipad right outside ED would make.

“With the support of the air ambulances and the excellent emergency care team at Hull Royal Infirmary, this unique mix of helicopters, helipad and hospital medical staff will make a huge difference to those people who may need life-saving treatment urgently.”

Patients were previously flown to the helipad on the other side of the hospital car park on Argyle Street and had to be transferred to Hull Royal in an ambulance along Anlaby Road, one of the busiest roads in the city centre.

Intensive Care Consultant Dr Tom Cowlam, the trust’s clinical lead for the MTC, said: “The new helipad will shorten the journey by a quarter of an hour and remove the need for the patient to be transferred in a second ambulance to the Emergency Department.

“It will make the transfer quicker and more seamless for the trauma patient.

“When you have a really poorly person, this might be the difference between life and death because this could be the time when they are having surgery or a massive blood transfusion to save them.”

Duncan Taylor, Director of Estates, Facilities and Development, said the trust funded the demolition of the Haughton building among others and clearance of the site before main contractor Unico Construction could begin work on the helipad.

Measuring 30 metres by 30 metres, 900 tonnes of concrete were brought onto the hospital site, over the course of one day.

An access road for fire engines and service vehicles has been built alongside a second pedestrian route where patients will be carried out of the air ambulance and rushed into the ED.

Special double fences have been erected around the helipad as “baffles” to reduce noise pollution, provide security and the majority of the site has been turfed with pinned grass covered with mesh overlay to act as a “soakaway” to remove water from the helipad.

Lights have been imported from Holland to be set into the concrete, now covered in specialist paint.

Hull is one of the country’s 27 Major Trauma Centres (MTCs), credited with saving an additional 1,600 people’s lives since they were established in 2012.

Lincs and Nott Air Ambulance use the Hull helipad most often, with Yorkshire Air Ambulance and Derbyshire, Leicester and Rutland Air Ambulance also flying casualties to the city.

The Search and Rescue helicopter, based at Humberside Airport, also lands in Hull with people winched off mountains or those injured on oil rigs or out at sea.

The helipad will also be used by the Children’s Air Ambulance, which can fly specialist medical teams into Hull to treat seriously ill children as well as fly children from here to hospital with specialist paediatric services.

To support the HELP Appeal please call the donation helpline on 0800 389 8999 or text HPAD22 plus the amount and send to 70070.

Hull’s main landmarks will turn pink next week to mark Organ Donation Week.

The Deep, the KC Stadium, St Stephen’s shopping mall and buildings including City Hall, The Maritime Museum and Queen Victoria’s statue in Queen Victoria Square will all shine bright pink on September 7.

The event celebrates the contribution of dozens of families who have agreed to donate the organs of their loved ones to save the lives of others.

Fay Turner, Specialist Nurse for Organ Donation at Hull University Teaching Hospitals NHS Trust, said: “We are so grateful to the support of so many organisations in the city to help us spread the message.

“Donating organs saves lives. Talk to your family and friends about your wishes. Make sure they know what you want to do in the event of your death.

“By donating your organs, you can save a mother, father, son or daughter being taken away from their loved ones too soon.

“This year in particular, when so many families have lost someone dear to them because of Covid-19, that message has never been more crucial.”

Last year, 42 patients received a life-saving or life-changing transplant after Hull families consented to organ donation.

While the impact of Covid-19 has seen a decrease in organ donations, four families have still donated their loved ones’ organs since the height of the pandemic in April to ensure other people have the chance to live.

Organ Donation Week will run from September 7 to 13. Social media platforms will be used by organisations this year, including the trust, to encourage more people to agree to organ donation in the event of their deaths and to share their wishes with their family.

The law about organ donation changed earlier this year to an “opt out” system. Also known as Max and Keira’s Law, the legislation change means you will be considered to have agreed to donate your organs unless you have specifically opted out.

Unless you are in an excluded group, have recorded your decision not to donate on the register or have informed your family that you do not wish to donate your organs in the event of your death, it will be considered that you have agreed to organ donation.

Watch the video to find out how transplants can make sure a difference to so many people.

Eight lucky members of staff have received bikes thanks to the generosity and support of charity R-evolution.

The Cottingham charity teamed up with Up! – the trust’s programme to support fitness and happiness at work – to offer staff the chance to win a free bike after it was awarded funding from the Big Bike Revival to refurbish bikes for key workers.

The charity provides training for people from all backgrounds including ex-offenders, people with mental health problems or those struggling to find work, unlocking and developing skills.

The eight members of staff receiving bikes are Sarah Atkins, Janice Jackson, Karen East, Anna Fraser, Mohamed Mohamed, Jane McCulloch, Aimee Cooney and Ellen Pattison. Two other members of staff – Yvonne Jackson and Jenny Chapman – were offered free servicing of their own bikes.

Simon Nearney, Director of Workforce at Hull University Teaching Hospitals NHS Trust, said: “What a fantastic gesture from R-evolution, a great charity making such a difference to people’s lives.

“Thanks to their generosity, these members of staff can now cycle to and from work and spend quality time with their families outside of work.

“We don’t just see it as our responsibility to look after people while they’re working. Their entire health and wellbeing, inside and outside work, matters to us.

“That’s why we set up our Up! programme earlier this year. Although we’ve had to pause some of our plans because of the pandemic and need for social distancing, we’re doing everything we can to help our staff to stay happy and healthy while looking after the environment.”

Lots of hospital staff are using the pandemic to improve their lifestyles and get more exercise. Many are opting to cycle to and from work, taking advantage of quieter roads, lighter nights and warmer weather (sometimes).

The trust has responded by offering secure bike lockers and sheds for staff to keep their bikes and is working with both Hull City Council and East Riding Council to offer cycling refresher courses.

Other initiatives are planned for the coming months, including changing facilities for staff, a bike forum for staff and maps to help people plan their routes to and from work using the most cycling friendly routes through the city.

The charity offered eight of the refurbished bikes with helmet, locks and lights worth a total of around £120, to our staff. The winners entered the competition, explaining why owning a bike would make such a difference to them.

John Marshall, Chief Executive of R-evolution, said: “It was great to hand over the bikes to the staff and we hope they’ll have many happy miles on them.

“Cycling is a fantastic form of exercise, boosting not just your physical but your mental wellbeing, and we’re really glad to be doing something for the staff who dedicate their working lives to helping others. Cycling to work is not only good for your health, it benefits the environment and cuts congestion.

“This is just the latest link up with the trust and we’ve got more events in the pipeline.”

Hull University Teaching Hospitals NHS Trust is looking for volunteers aged 70 and over to take part in our trial of a vaccine for COVID-19 developed at the University of Oxford.

Patient information sheets which offer more details about the study can be found on the trial website: https://www.covid19vaccinetrial.co.uk/participate-hull-1

Consultant in Infectious Diseases and principal researcher for the vaccine trial in Hull, Patrick Lillie, said:

“Researchers need to trial the vaccine in people of all ages to make sure the vaccine is effective no matter how old someone is. Participation in this trial could really make a difference during the Covid19 pandemic.

“We need healthy people aged 70 and over to contact us. In general, COVID-19 is more dangerous for older people, so a vaccine would be particularly beneficial for people in older age groups. The vaccine does not contain the virus so it is impossible to catch coronavirus or develop COVID-19 from the vaccine itself.

“I would urge people to contact us and help us with this vital study.”

Anyone interested should click on the ‘Pre-Screening Questionnaire’ button and complete the online form at https://www.covid19vaccinetrial.co.uk/participate-hull-1

If you have any questions about the study please don’t hesitate to contact us: hyp-tr.huth-oxvaccinetrial@nhs.net