DEAR DR. ROACH: About a year ago, a test revealed that I had an 8-mm stone in my kidney. My kidney doctor was not worried about it. I have had no infections or symptoms, and I have normal kidney function. My general doctor recommended a urologist.

All three doctors thought that it was 50-50 whether it would just stay there forever and that there was really no issue waiting for it to dislodge. But if it did try and pass, it would take surgery. Now less than a year later, over the phone, my urologist is telling me at 74 years old that I should immediately get the surgery; otherwise they will have to put in a temporary stent and have to replace it every three months for as long as I live.

I am going to get a second opinion. My real issue is being 74 years old. I am in very good health. I exercise regularly. I felt pressured to have the surgery due to a fear of replacing the stent every three months versus removing the stone now. What are your thoughts? — M.A.R.

ANSWER: Kidney stones are common. The goals of treatment are to relieve symptoms and prevent infections as well as the loss of kidney function. Since you have not had an infection, have no symptoms, and have normal kidney function, there is no need for acute intervention that I can see.

It is possible that the kidney stone is in a location where it looks like it could potentially cause an obstruction, so I can’t say for sure that there will never be a need to treat the kidney stone. But I agree with you that a second opinion is wise.

DEAR DR ROACH: I’m a 79-year-old male in reasonably good shape. I am 6 feet, 2 inches tall, and weigh 210 pounds. During a colonoscopy, the doctor noticed that the head of my pancreas was way larger than it should be. I saw a surgeon who advised that it was precancerous after an MRI and a biopsy. I decided on Whipple surgery and will be getting it done in about a month.

Could you please give me your thoughts on Whipple surgery? I’d mainly like to know the risks of using robotics in the surgery and if it is much better than traditional surgery. But I’d appreciate your thoughts on the whole deal. — M.D.

ANSWER: In the 1970s and 1980s, a Whipple procedure was a very high-risk surgery, with over 15% of people not making it through the surgery. A Whipple surgery removes the head of the pancreas, part of the duodenum, the gallbladder, and the bile ducts. In the best centers now, the operative mortality is less than 4%, which still makes it a risky procedure that should only be contemplated when there aren’t any better options.

The decision to choose a particular procedure is generally done by the surgeon after a careful evaluation of the patient’s particular anatomy. I suspect that your surgeon gave you other options, such as surgeries that preserve part of the stomach. Even though I have more expertise than most laypeople, I still accept whatever my surgeon said was the best option.

The data on robot-assisted surgery versus traditional surgery show no difference in the success of removing the cancer (precancer in your case), mortality, reoperation, or readmission. But the robot-assisted surgeries have less blood loss, fewer wound infections, and shorter lengths of stay. These are both long procedures (about 5.5 hours for traditional and almost 7 hours for robot-assisted on average), and recovery takes weeks to months.

With both a traditional Whipple and robot-assisted procedure, the experience of the surgeon and institution is critical. You really want to be in a hospital that performs many of these procedures.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2025 North America Syndicate Inc. All Rights Reserved