Veterans Anesthesia Division | Renaissance School of Medicine at Stony Brook University

The Division of Veterans Administration Anesthesia provides anesthesia services to veterans at the VA Medical Center in Northport for a wide variety of cases in General Surgery, Vascular Surgery, Thoracic Surgery, Urology, Orthopedics, Otolaryngology, Oral Surgery, Ophthalmology, Plastic Surgery, Gynecology, Podiatry and Psychiatry. The service also provides care for cardioversion, endoscopy, special procedures, and emergency airway management outside of the operative setting. The division also includes active acute and chronic pain management services and an active Pre-Admission Testing Center.

Matthew Giuca, MD is Chief of the Division.
Joseph C. Caballero, MD
Joseph Conrad, MD
Rolando R. Joco, MD
Riazur M. Rahaman, MD
Ravi Shanker Srivastava, MD

The Division of VA Anesthesia provides residents with a complete and diverse experience. The focus is on practical training and didactic instruction caring for geriatric patients with multiple co-morbidities undergoing a variety of complex surgical procedures. Residents gain extensive experience providing perioperative care for patients undergoing elective and emergency general surgery, vascular, thoracic, urology, ENT, orthopedic, ophthalmology, podiatry, gynecology, plastic surgery, and oral surgery procedures. In addition, residents learn to provide anesthesia for electroconvulsive therapy, cardioversion and endoscopy, and to use advanced airway management techniques.

CA-1 residents undergo an extensive orientation at the VA Medical Center and participate in the care of patients undergoing the entire gamut of surgical procedures at the VA including elective vascular and thoracic surgical procedures. They also gain experience in pre-operative assessment in the Pre-Admission Testing Center and in acute pain management.
CA-2 and CA-3 residents participate in the perioperative management of more complex and clinically challenging cases. In addition, residents may elect to rotate through the chronic pain management center and gain experience in patient evaluation and related procedures including epidural steroid injections, trigger point injections, stellate ganglion blocks, facet joint injections, celiac plexus blocks and peripheral nerve blocks.

▶ A day in the life of a Resident on the VA rotation.

The Northport VA Medical Center, situated 2 miles east from the heart of a lively, tranquil downtown harbor with an elite crowd and 3 miles west from the bustling boardwalk at the Sunken Meadow State Park beach, welcomes Anesthesia Residents the opportunity to witness the unique experience in caring for the geriatric Veterans.

Just 13 miles away from Stony Brook, the VA provides a break from the Level 1 trauma, cardiac and laboring OB patients. Instead, there is a wide range and variety of OR cases, from cataract procedures requiring monitored anesthesia care to complicated general surgery and vascular cases requiring full-blown general anesthesia with arterial and central line access. There is also a good number of thoracic cases with double-lumen tube placements, and bronchoscopy cases where we learn to share the airway with the pulmonologists. We have the opportunity to induce a seizure with methohexital for the ECT cases and be on standby for the high-risk patients undergoing colonoscopies, both with its own risks. Because there isn’t a separate acute pain service, we get to place our own neuraxial and peripheral nerve blocks. Another important distinction at the VA is the home call system, which allows time for family and personal needs during the late nights and weekends.

Morning cases start at 8am and usually finish by 4-6pm. We arrive at 7am and have ample time to get the anesthesia workstation ready and see the patient for the first case. The post-call Resident is usually relieved by 3-4pm. The on-call Resident stays until the last patient is discharged from anesthesia service care.

With 4 running ORs, 1 urology suite, a special procedure room and 2-3 GI suites, there are 5 general Anesthesiologists and 1 Pain Anesthesiologist. Each attending has a strong personality and his/her own VA story to share. With time, we come to love them all and appreciate their dedication to teaching and compassion to their patients. They provide breakfast during morning lectures and a surprise feast for lunch at the end of the rotation. Vital to our staff, we are fortunate to have two great Anesthesia Techs, Dan & Darryl, during the week. They are efficient and reliable when it comes to restocking our medications and supplies. Likewise, Brenda, the Secretary and Jasmine, the Medical Support Assistant, are hardworking and reliably efficient in taking care of our VA Access codes, pharmacy codes, electronic computer workstations and other Resident related matters.

The VA OR team wouldn’t be the same without the Nurses and Surgeons. The Nurses, many of who have worked >5-10 years, are diverse and family oriented. The Surgeons vary in their experience, skills, and surgical times. Drs. Lo, Sorrento, David, and Abbas are among the favorites in training Residents and Medical Students.

Lastly, the VA Northport campus has a golf course with discounts for Residents and housing–dormitory style available (monthly cost $230) for those who wish to live and become part of the VA Northport family.

Resident authors denoted by bold type

Ballacchino MM, McQuestion CC, Giuca MS, Dosluoglu HH, Nader ND. The Use of Frailty Scores for Screening the Surgical Risk Benefits: A Multidisciplinary Approach. Ann Surg. 2024 Jul 23.

Cervo K, Giuca M. A Difficult Airway And Complex Pulmonary History Undergoing High Risk Surgery: How To Proceed? ASA 2022
Ballacchino M, Gajdos C, Giuca M, McQuestion C, Schuler C. The Use of Frailty Scores for Screening the Surgical Risk Benefits: A Multidisciplinary Approach. PGA 2023