Hospital Affiliation: MidHudson Regional Hospital; Vassar Brothers Medical Center; Nothern Dutchess Hospital
When Paul K. Pietrow, MD, FACS, was finishing his fellowship in minimally invasive surgery (MIS) in 2001, the specialty was still in its infancy and MIS robotics was just emerging. According to Pietrow, the field has really grown up in the past 14 years: “When I first came out of my fellowship, I was part of a very small cohort; I was recruited to the Hudson Valley because there weren’t many doctors in this field with my training and skill set. But that’s no longer the case, and now I’m just running with the pack. Throughout the Valley, minimally invasive has become mainstream — and that’s a great thing for our patients.”
Specifically, Pietrow points to the increasingly positive results for patients fighting kidney cancer. “Today, people are readily scanned, and this means we are finding kidney tumors earlier, when they are small and still contained,” he says. “And that’s where minimally invasive surgery comes in. We can operate on people without a big incision, and get great cure rates due in part to our increasingly advanced techniques.”
How have the advances in MIS technology changed the way you treat your patients today?
The big leap was from open surgeries to laparoscopic [minimally invasive] surgeries, and that was really exciting to watch. Now it’s also exciting to watch as we incrementally improve. As we push to do more complex surgeries less invasively, these incremental advances come in the form of better tools and also better laparoscopic techniques. In fact, the robot is just a really fancy set of laparoscopic tools, that allows us to do more complex procedures by making us more facile, giving us more dexterity, and making us more precise.
How does this impact my practice?
Specific to kidney surgeries, I only perform about three open surgeries a year. The rest are done using minimally invasive technology. And of all of these surgeries I perform, about two-thirds are using the robot. Today, we can take out part of a kidney and remove a tumor and send the patient back home the very next day.
Why are more and more adults developing kidney stones?
It’s not just one variable. Obesity increases stone risk. There was also a recent study that shows drinking large quantities of soda increases your stone risk. But, in general, the American diet has not been very healthy over the past few decades.
Maybe it’s because we have so many farms in the area, or maybe because the Valley has such a large culinary influence, but I have noticed a push toward local, farm-to-table, healthier eating here — and perhaps this movement will turn this around in the Hudson Valley.
What do you tell your patients about maintaining kidney, bladder, and prostate health?
Of course, genetics play a role, but, when it comes to the things we can control, I tell them, heart healthy is prostate healthy. And heart healthy is kidney healthy. There is not a lot of magic to it. It’s eating well, keeping your weight down, and exercising. I tell my patients to follow a Mediterranean diet: heavy in fruits and vegetables and grains. Not too much red meat. Get your olive oil and your avocados and your fish. And maybe drink a little red wine — but not too much! These things will keep you healthy.