The Hernia Center at Staten Island University Hospital
Staten Island, New York 10305
The Hernia Center of Staten Island University Hospital is led by Dr. Michael R. Castellano, MD, FACS. Having personally performed thousands of successful hernia surgeries, Dr. Castellano is proficient in both open and laparoscopic surgery. The Hernia Center is composed of a dedicated team of nurses, surgical technicians and anesthesiologists who work together on a continual basis.
With vast experience in hernia repair, our expert staff brings the latest advances in technology and medical techniques to our patients throughout the Staten Island area. We offer a range of treatment options in our modern, state-of-the-art facilities, including minimally invasive repairs done on an outpatient basis, complex procedures, and sophisticated surgery. With our commitment to providing the latest techniques with caring hands, our team remains consistently up to date by conducting research and promoting residencies.
Our goal is to improve our patients' overall quality of life by providing effective and personalized treatment with the least possible discomfort, minimizing the chances of pain and future complications. Contact us to learn more about your treatment options.
Our Hernia Center specializes in the treatment of many different types of hernias, including:
What is a hernia?
A hernia is a hole in a muscle. The abdominal cavity is essentially a basket of muscles holding your organs within it. A weakness in the basket will often lead to a hole, which is by definition a hernia. Symptoms may develop as the hole becomes larger or when internal organs, usually intestines, begin to push through the hole.
What causes a hernia?
Heavy lifting, excess abdominal weight, chronic coughing, pregnancy, sports injuries and straining due to constipation are common causes, but some hernias are present at birth and can worsen with time.
What is an incarcerated hernia?
Incarceration means that something, usually intestines or intra-abdominal fat, is stuck within the hernia in the abdominal wall. This can lead to obstruction of the intestines, which can result in severe pain, bloating, nausea and vomiting. This condition may progress to strangulation, which involves compromised blood flow to the organ stuck within the hernia. These can often become emergency situations and are best avoided if possible.
What are the symptoms of a hernia?
The most common symptoms of a hernia are discomfort and swelling. Discomfort can range from an intermittent twinge or dull ache to severe pain or burning. Swelling can range from either mild asymmetry or swelling to a large, firm lump. Severe acute pain associated with a firm lump should be given prompt evaluation.
How is a hernia diagnosed?
Most hernias can be diagnosed by physical examination from a qualified healthcare provider. Symptoms suggestive of a hernia, without obvious physical evidence of one, warrant an evaluation by a surgeon with expertise in this area. On occasion, a sonogram, CT scan or MRI may be necessary.
How is a hernia treated?
If a hernia is small and not causing any symptoms, watchful waiting may be acceptable. However, if a hernia protrudes or if any symptoms are present, then it should be repaired.
Most hernias repaired by the Hernia Center at Staten Island University Hospital are done in about 30 minutes as an outpatient procedure. Most are done without general anesthesia, utilizing local anesthesia with IV sedation instead. This is safer, more comfortable and less stressful for most patients.
Most hernias are repaired using small incisions and minimally invasive techniques. Soft, flexible meshes are often used to repair hernias in a “tension-free” fashion, resulting in less pain, quicker recuperation and less chance of recurrence.
Can I reduce my risk of developing a hernia?
Yes. Avoid lifting heavy objects and, when lifting is necessary, lift and bend from the knees, not the waist. Moving furniture, carrying suitcases, shoveling snow and lifting weights at the gym are common activities resulting in hernias.
It’s also helpful to maintain a healthy weight by adopting a healthy lifestyle. Eat less and move more. A healthy diet with minimal processed food and lots of fiber will usually eliminate constipation, which is a common cause of hernia formation, especially in older people.
Finally, stop smoking if you do. This dangerous habit often leads to a chronic cough, which can result in a hernia among other health problems.
With improved technology and advances in anesthesia and pain control, many less invasive surgical procedures are now being performed on an outpatient, or ambulatory, basis, including hernias.
Not all patients are candidates for outpatient surgery and some procedures still require hospitalization. A patient's medical history and the advice of the surgeon and anesthesiologist are important in determining if the procedure is best performed on an outpatient or inpatient basis.
Benefits of outpatient surgery
There are many advantages of outpatient surgery over traditional inpatient surgery. These include the following:
- Convenience. The convenience of recovering in your home generally makes recovery time quicker and easier than an in-hospital stay.
- Lower cost. Since there are no hospital charges, costs are much lower for outpatient surgery. Some insurance companies will cover certain surgical procedures only on an outpatient basis, unless your physician certifies that you require a more intensive level of postoperative care due to an underlying medical condition.
- Reduced stress. In the majority of cases, outpatient surgery is less stressful than inpatient surgery. This is especially true for children who are afraid of being away from home.
- Predictable scheduling. In a hospital setting, emergency surgeries and procedures that take longer than expected can delay scheduled surgeries. An outpatient setting can generally stay within a set schedule since the procedures are less complex and more routine.
Outpatient surgery safety for elderly patients
Age alone is not a reason to disqualify an elderly patient from having outpatient surgery. However, it does affect the reaction of elderly patients to certain anesthetic drugs, as short-acting drugs often take a longer time to be metabolized by the elderly. Older people may also have more underlying medical conditions that could make an outpatient surgery riskier. It is important for an elderly patient to have a thorough medical evaluation before any surgery to determine the best surgical setting for that individual.
Discharge after surgery
The scheduled time of discharge depends on the type of surgery, the anesthesia used, insurance coverage, and the policy of the surgery center. In general, most patients go home between one and four hours after outpatient surgery. The anesthesiologist can give you more specific information based on your case. Occasionally, it is necessary for a patient to remain overnight. All ambulatory surgical facilities have arrangements with a hospital if this becomes necessary.
Responsibilities of the ambulatory patient upon returning home
Patients who undergo an outpatient procedure should have someone to drive them home and stay with them following the procedure. Most patients are restricted from driving for 24 hours after surgery.
Patients often experience drowsiness and minor after-effects, such as muscle aches, sore throat, and occasional dizziness and headaches. Occasionally, nausea may also be present. There may also be fatigue and discomfort for a day or two following the surgery.