What happens during a C-section?

DEAR DOCTOR K: My doctor says she is going to have to deliver my baby by C-section. What will happen during this procedure?

DEAR READER: A cesarean delivery, or C-section, is surgery to deliver a baby through the abdomen. It may be scheduled in advance when a woman cannot or should not deliver the baby through the vagina. A C-section may also be performed if continuing with labor or delivery becomes risky to the mother or baby. Finally, a cesarean may be done as an emergency procedure if there is immediate risk to a mother or baby.

Should I be worried about complications from a hip replacement?

DEAR DOCTOR K: My doctor says I need hip replacement surgery. She says it will help my pain. But I'm worried about complications. Should I be?

DEAR READER: I get a lot of questions about hip replacement surgery, and I'm in a good position to answer them: I had a hip replacement about a decade ago. Before I give a more detailed answer, let me cut to the chase: The benefits of hip replacement surgery greatly outweigh the risks.

Non-surgical treatments for fecal incontinence

DEAR READER: In yesterday's column I discussed non-surgical treatments for fecal incontinence. Today, I'll discuss surgical treatment options. When everything works properly, feces move from the colon into the rectum, which sits at the end of the digestive tract. The rectum has walls that stretch to hold the stool. Two circular muscles are present in the last inch of the rectum, or anal canal.

Do I have any say in the type of anesthesia the doctor uses for a minor surgical procedure?

DEAR DOCTOR K: I have a minor surgical procedure coming up. Will I have any say in the type of anesthesia the doctor uses?

DEAR READER: For some surgical procedures, more than one type of anesthesia may be appropriate. The doctor who will administer the anesthesia (the anesthesiologist) will talk to you about the options. I spoke to Dr. Kristin Schreiber, an anesthesiologist at Harvard-affiliated Brigham and Women's Hospital. She explained that anesthesia has four goals. The first is to make sure you have no pain; the second is to make you drowsy or unconscious. The third is to keep your body still during the procedure -- you don't want your surgeon to have to deal with a moving target. And finally, the fourth is to prevent bad memories of the procedure.

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.