Groundbreaking Northwell Health kidney surgeon retiring at age 84

More than four decades ago, Dr. Arthur Smith helped invent a type of surgery that often removes painful and sometimes dangerous kidney stones without making large cuts in the body.

On Monday, the Northwell Health physician, 84, will see his last patients at the New Hyde Park institute that now bears his name. But his legacy will remain after his retirement. Surgical kidney stone patients today typically have less pain, quicker recovery and less scarring than before the technique he developed.

"He really is a giant in the field and someone who really has moved the needle in a major way," said Dr. Marshall Stoller, who heads the urinary stone division at the University of California, San Francisco. "He was a true pioneer of popularizing minimally invasive surgery, which means we went from big knives making [large] incisions to be able to make small incisions or go through natural orifices to deal with kidney stones. He inspired people close by, like in New York, and people far away like myself in San Francisco."

Kidney stones are deposits of minerals — most often calcium — and salts in the kidney that, according to the American Kidney Fund, can range in size from a grain of sand to a golf ball. Small kidney stones can be "passed" through urination. Larger ones may require surgery.

Kidney stones can lead to severe pain, and "if they’re not treated, they can cause destruction of the kidney and loss of kidney function," Smith said.

While at the University of Minnesota in the late 1970s and early ’80s, Smith said he and Dr. Ralph Clayman — then a medical resident and now a professor of urology at the University of California, Irvine — developed minimally invasive kidney stone surgery.

"In the past, people used to have a 10- to 12-inch incision in their back to get to the kidney and then take out stones," Smith said.

Smith’s technique required only a small needle puncture, with a tube inserted into the kidney, he said. Doctors use medical instruments and a tiny camera in that tube to operate.

"You can visualize the stone directly, break up the stone and remove it," he said.

Dr. Louis R. Kavoussi, chairman of urology for Northwell Health and head of the Arthur Smith Institute for Urology, said Smith "revolutionized how kidney stones are treated today … and he was a huge part of starting the revolution" toward minimally invasive surgery in general.

"Over the years, he has been very humble about this. He gives Ralph a boatload of credit," Kavoussi said, referring to Clayman, who supervised Kavoussi when he was a medical resident. "Ralph does get credit for being there with him, but it was really Arthur who had the vision and who pushed it."

Smith helped found the Endourological Society in 1983 to promote minimally invasive urology surgery and served as the group’s president until 2004. Stoller said the society’s annual meetings around the world now attract thousands of people.

The Journal of Endourology, which Smith cofounded, also increased knowledge of minimally invasive procedures, Stoller said. Smith said he plans to remain co-editor of the academic journal after his retirement from Northwell.

Smith was born in South Africa and, after five years at the University of Minnesota, he arrived at what is now Northwell in 1982, serving first as division chief and later as chairman of the urology department at Long Island Jewish Medical Center in New Hyde Park until 2006. He also has been a professor at the Zucker School of Medicine at Hofstra/Northwell in Hempstead.

But his passion has been caring for patients. Smith said he performed more than 5,000 kidney stone surgeries and thousands of other urology operations. Urology includes treatment of the kidney, bladder, urethra and prostate.

"I like to treat people, I like to interact with them, and I like to help them and resolve their problems," Smith said. "That’s why I went into medicine to start off with."

Longtime patient Linda Lettieri, 75, of Blue Point, said Smith is "extremely knowledgeable and well-versed in his field. But at the same time, he’s very attentive, and he listens to what you say."

Patient Gerard Rosenthal, 83, takes two subway trains and a bus from his Manhattan apartment to see Smith, whom he described as "very low key, without any ego." He has been making the trip — usually about twice a year for checkups — since Smith operated on him in 2001 to remove part of his prostate.

"He gave me his cellphone number, his home number and said, ‘Anything you need, just call me,’ " he said.

Smith is looking forward to spending more time with his wife, Kay-Ellen Smith, 82, in their Manhasset home. The couple have four children and 13 grandchildren.

"You want to retire when you feel it’s the right time," he said. "I’m 84 years old. That’s a good enough reason."

By David Olson

david.olson@newsday.com@DavidOlson11

David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.