Surgery

Can you have a bypass surgery and angioplasty at the same time?

DEAR DOCTOR K: My friend said he had bypass surgery and angioplasty at the same time. Isn't it usually one or the other?

DEAR READER: It is usually one or the other, but your friend may have been treated at one of a few select medical centers in the United States currently offering a new hybrid approach. If so, he may have had both bypass surgery and angioplasty during the same surgery. To answer your question, I need to explain both the traditional approach and then the new hybrid approach. The hybrid approach cannot be used in all patients. However, when it is used, the goal is to make the surgery less grueling, and the beneficial results of surgery more long-lasting.

Why do doctors remove the appendix when someone has appendicitis?

DEAR DOCTOR K: Why do doctors remove the appendix when someone has appendicitis? Don't we need this organ?

DEAR READER: Appendicitis is an inflammation of the appendix. This small, fingerlike tube hangs from the lower right side of the large intestine. It usually becomes inflamed because of an infection or blockage. The condition is quite common; it affects one in every 500 people in the United States each year. (I've put an illustration of an inflamed appendix below.)

Do I need surgery to have my gallstones removed?

DEAR DOCTOR K: I was recently diagnosed with gallstones, and my doctor recommended surgery. Is this the best option, or can I consider other treatments?

DEAR READER: Gallstones are pebble-like deposits that form inside the gallbladder, a pouch that sits below the liver. It collects bile that has been made in the liver, then releases it into the small intestine through narrow tubes called bile ducts. Bile is a fluid that helps with digestion. It contains salts, cholesterol and bilirubin.

How are abdominal adhesions treated?

DEAR DOCTOR K: I had abdominal surgery last year. Soon after, I started experiencing severe pain and swelling in my abdomen. It turns out I have abdominal adhesions. I'd never heard of them. What are they, and how are they treated?

DEAR READER: Abdominal adhesions are bands of fibrous scar tissue. They can cause organs that are normally not connected to stick to one another or to the wall of the abdomen.

During an angioplasty, why is the catheter inserted through the wrist?

DEAR DOCTOR K: I am scheduled to have an angioplasty next week. The doctor plans to insert the catheter through my wrist. Is there some advantage to doing it through the wrist rather than the thigh?

DEAR READER: Angioplasty is a procedure used to open a narrowed or blocked artery. Angioplasties are usually done to open up blocked coronary arteries -- the blood vessels that provide blood to the heart muscle. The blocked coronary arteries lie deep within the chest.

Is there a surgical fix for obstructive sleep apnea?

DEAR DOCTOR K: Is there a surgical fix for sleep apnea? I've tried CPAP and a couple of other treatments, and none of them work well for me.

DEAR READER: Sleep apnea is a condition in which breathing stops intermittently, or becomes shallower, during sleep. Obstructive sleep apnea (OSA) is the most common form. OSA occurs when muscles in the back of your throat relax as you sleep. This causes the airway -- the space in the back of your throat through which air passes when you breathe -- to periodically collapse. If air can't get into your lungs, oxygen levels in your lungs drop, which then causes oxygen levels in your blood to drop.

What are the surgical options for a herniated disk?

DEAR DOCTOR K: I have a herniated disk that's been bothering me for more than a year. I've tried exercise, medication and complementary therapies. None have helped. What are my surgical options?

DEAR READER: Let's start with a brief anatomy lesson. The human spine consists of a column of interlocking bones called vertebrae. They surround and protect the spinal cord. Vertebrae are stacked on top of each other. In between each pair of vertebrae is a little shock-absorbing cushion called an intervertebral disk. Intervertebral disks -- think of miniature jelly doughnuts -- prevent the vertebrae from scraping against each other. A normal disk has a jelly-like center (the nucleus) and a tough outer covering.

What is laparoscopic surgery?

EAR DOCTOR K: I need to have surgery in my abdominal area. My surgeon said he can do it "laparoscopically." What does that mean?

DEAR READER: It is good news. It means that the surgery you'll have will involve cutting through less tissue, and it will be easier to recover. Forty years ago, abdominal surgery would have required a relatively large incision. The surgeon had no way of looking at your insides and seeing what needed to be fixed or cut out.

What replacement lenses should I chose after cataract surgery?

DEAR DOCTOR K: I'm having cataract surgery in a few weeks. There are so many options for replacement lenses. Which one should I choose?

DEAR READER: I can't tell you which you should choose, since I don't know the specifics of your cataract. But I can suggest how you should think about several options that your ophthalmologist is likely to discuss with you.

Can you explain what will happen during LASIK eye surgery?

DEAR DOCTOR K: I've just scheduled LASIK surgery. Can you explain what will happen during the procedure?

DEAR READER: To understand LASIK surgery, you first need to know a few things about the eye and what it does. Basically, your eye is like a camera: It focuses the light coming into it to make a sharp image. That image then is captured on a kind of film (or, in digital cameras, a sensor).