Ask the doctor - surgery

Read expert medical advice with doctors' questions and answers from Prima, SHE and Good Housekeeping

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Surgery fears
I need to have my gallbladder removed because of a large stone. The surgeon says he'll try to do it using keyhole surgery, but what are the chances of waking up and finding I've had a conventional open operation?

The most popular way to remove the gallbladder is by keyhole surgery, which is attempted in 95 per cent of cases. If difficulties are experienced during laparoscopy, the surgeon will immediately convert to
an open operation. This is not a failure of surgical technique, simply
safe practice. Conversion to an open operation occurs in less than one per cent of operations for uncomplicated gallstones. If you have cholecystitis (an infected gallbladder), the associated scar tissue and thickening of the gallbladder means there is a five per cent chance of the surgeon converting to an open operation. Your surgeon can tell you about his or her personal statistics in this regard.

Dr Sarah Brewer, Prima (Oct 09)

 

How can I avoid MRSA?

As I'm soon to be admitted to hospital for an operation on my knee, I'm very concerned about picking up the superbug infection MRSA while I'm in there. Is there anything I can do to help stop me catching it?

MRSA (Methicillin-resistant Staphylococcus aureus) is resistant to traditional antibiotics, making it harder to treat than standard infections. It's usually passed on by human contact, though it can be spread by towels, sheets or clothes used by someone else who has it.
You can be an MRSA carrier without having any symptoms, which is why some hospitals screen patients before they're admitted, taking skin swabs and urine and blood tests, to keep the infection out of the
hospital. If you are an MRSA carrier, you may be given treatment before admission to eliminate the bacteria, in the form of an antibiotic cream and antiseptic wash. Once you're in hospital, follow simple hygiene: wash hands carefully after using the bathroom; wash them before and after meals and ask people to wash their hands carefully
before visiting you. Hospitals publish their MRSA infection rates at the Department of Health website at www.dh.gov.uk.

Dr Louise Selby, SHE (Sept 09)

 

Being a carrier for MRSA

I recently had a pre-operation assessment and was horrified to be informed that I was a carrier for the ‘superbug’ MRSA. I was given liquid to wash in and a cream to apply to my nostrils for a week and have now been told that it’s gone. I thought MRSA was always serious and often a killer.

Despite all the publicity, and the fact that cases of MRSA are undoubtedly rising in the UK, in the majority of cases it does no harm at all. Like you, many people ‘carry' it on their skins, and it causes problems only if it gets into the body - through a wound after an operation, for example. The treatment you had has a very high success rate in getting rid of the bug, and if you have the all-clear you can be completely reassured. Of course, in a hospital setting, it's a cause for concern, but it's still an extremely rare cause of death, particularly in younger people - say, under 75 years old - who are otherwise in good health.
Dr Sarah Jarvis, Good Housekeeping

 

MRSA concern

When I went into hospital for a routine check-up the doctors told me that they had found MRSA in my nasal passage, but no sign of infection. Since then I’ve heard that a deadly form of MRSA can affect healthy adults. Should I be concerned?

MRSA is a strain of the bacterium Staphylococcus aureus, a bug carried harmlessly by about one in three people. Problems with MRSA traditionally occur in hospitals, where people are vulnerable to infection.
Its resistance to most conventional antibiotics also makes it tough to treat.

I think the deadly strain you’re talking about is PVL MRSA. It does seem to be more virulent than previous strains of MRSA and isn’t confined to hospitals. But it is very rare in the UK, with just seven associated deaths in the last two years, so I don’t think you should worry. Simply washing your hands is the most important measure to help prevent contamination – invest in an antibacterial hand gel, such as NO-GERMS Instant Hand Sanitizer (available nationwide).
Dr Louise Selby, SHE

Do I really need a hernia operation? 

I recently developed a lump in my groin, and my doctor has told me I’ve got a hernia and I should have an operation. Is this necessary?

Hernias are caused by weaknesses in the stomach wall, which let some of the intestine poke through. The groin is the weakest point in your abdominal wall, which is why hernias commonly occur there. Although they don’t usually cause problems, they do tend to grow and can become very uncomfortable. There’s also a small chance that the bit of intestine poking through will get stuck and squeezed, depriving it of blood. At best, this causes severe pain. At worst, it can be fatal. That’s why we usually recommend hernias are fixed – the operation is fairly minor and very successful.
Dr Sarah Jarvis, Good Housekeeping

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The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk