Prospective patients are seen at the Columbia Hernia Center for a consultation, which includes a comprehensive medical history, physical examination, and detailed discussion with the doctor. If patients have had prior abdominal or hernia surgery, they are asked to bring their operative reports and copies of any abdominal CT scans that were performed prior to their consultation. If the doctor recommends a hernia repair and the patient wishes to proceed with scheduling surgery, a date is chosen and pre-operative testing is ordered (blood, EKG, and chest x-ray when appropriate). Testing is usually accomplished in about 1 hour at the Hernia Center, but it may also be done near the patient’s residence if that is more convenient. Instructions are given regarding management of standing medications, diet, and bowel preparation, when necessary.
Day of Surgery
Surgery is performed at one of Columbia University Medical Center's sites in Manhattan — either at the main 165th Street location or at the Allen Hospital at 220th Street. 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.
Patients are advised that they should expect to experience some pain after hernia surgery, although it frequently proves to be less than they anticipate. Avoidance of certain movements, particularly contraction of the abdominal muscles when sitting up, helps to minimize pain. Strategies for reducing pain are discussed and medications are prescribed. Patients are encouraged to resume all normal activities as soon as they feel confident that they can do so without causing unreasonable pain. Normal diets can be resumed immediately. Most patients are able to return to work in 1 week or less, and to return to exercise regimens after 2 weeks. Patients may travel safely at any time after surgery provided they have checked-in with their surgeon and confirmed the stability of their health. Suture removal is not required as wound closures are performed with absorbable sutures.