Surgery may be performed at Columbia University Medical Center or at an outpatient surgery facility, The Manhattan Surgery Center, depending on the patient’s preference and the nature of the operation. All surgery requiring post-operative hospitalization is performed at the Medical Center. Patients are asked to report to the facility 90 minutes prior to the anticipated time of their procedure, in order to check in and be seen by their anesthesiologist. The anesthesiologist will examine the patient and review the patient’s medical history, focusing on prior surgery and any anesthetic concerns that the patient may have. Most ambulatory surgery operations, such as inguinal and umbilical hernia repairs, are performed under local anesthesia with additional relaxing and pain-relieving medication provided by the anesthesiologist to assure complete patient comfort. Ambulatory surgery patients who do not need general anesthesia are usually discharged from the recovery room within one hour of completion of their surgery. Prescriptions for pain medication are given and a follow-up appointment with the surgeon is scheduled.