Andrei I. Gritsiuta1, Jin Ye Yeo2
1Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 2ACR AME Publishing Company
Correspondence to: Jin Ye Yeo. ACR Editorial Office, AME Publishing Company. Email: acr@amegroups.com
This interview can be cited as: Gritsiuta AI, Yeo JY. Meeting the Editorial Board Member of ACR: Dr. Andrei I. Gritsiuta. AME Case Rep. 2024. Available from: https://acr.amegroups.org/post/view/meeting-the-editorial-board-member-of-acr-dr-andrei-i-gritsiuta.
Expert introduction
Dr. Andrei I. Gritsiuta (Figure 1) is a dedicated general surgery resident at the University of Pittsburgh Medical Center (UPMC). He earned his medical degree from Lomonosov Moscow State University in Russia. Dr. Gritsiuta completed his residency and fellowship in thoracic surgery at the National Medical Research Center of Surgery. In 2019, he received his Ph.D. degree, focusing on developing treatment modalities for chronic nonspecific pleural empyema. He further pursued a postdoctoral research fellowship in lung biology at the University of Pennsylvania in Philadelphia. Dr. Gritsiuta has enriched his clinical experience through multiple electives in cardiothoracic surgery at some of the world's leading institutions. These include Memorial Sloan-Kettering Cancer Center in New York, Rush University Medical Center in Chicago, and the University of Basel in Switzerland. He has also completed a specialized Robotic Thymectomy Course at the Charité Clinic in Berlin, Germany.
Dr. Gritsiuta has contributed to the medical field by authoring over 30 peer-reviewed publications and book chapters, focusing on minimally invasive thoracic surgery techniques. His translational research has explored integrated signaling networks in lung diseases and pulmonary hypertension. Dr. Gritsiuta has presented his work at 20+ local, national, and international conferences. In addition to his research and clinical work, Dr. Gritsiuta reviews articles for various journals in general and thoracic surgery. He is an active member of the American Medical Association (AMA), the European Society of Thoracic Surgeons (ESTS), and the American College of Surgeons (ACS). Dr. Gritsiuta will continue his training in cardiovascular and thoracic surgery at the University of Texas Medical Branch, where he looks forward to further developing his skills and contributing to patient care and medical research.
Figure 1 Dr. Andrei I. Gritsiuta
Interview
ACR: What drove you to specialize in thoracic surgery?
Dr. Gritsiuta: Choosing to specialize in Cardiothoracic Surgery was driven by a combination of personal interests, professional inspirations, and the impactful nature of the field. When questioning what specialty to pursue, the advice I was given was simple: "Choose the specialty where you love the patient population, the science behind the medicine, and the day-to-day work." From an early stage in my medical education, I was fascinated by the intricate anatomy and complex physiological functions of the thoracic cavity. It is a field that requires precision, resilience, and a deep understanding of the human body, all of which align with my professional aspirations and personal strengths. The challenge of operating on vital structures such as the lungs, esophagus, heart, and major vessels captivated my interest and motivated me to delve deeper into this specialty. Additionally, the field of thoracic surgery is at the forefront of medical innovation. The rapid advancements in minimally invasive techniques, such as robotic-assisted surgery, present exciting opportunities to continually improve patient outcomes. The dynamic nature of the specialty, with its constant evolution and integration of new technologies, provides a stimulating and rewarding professional environment. Mentorship also played a significant role in my decision. During my training, I was fortunate to work with highly skilled and passionate thoracic surgeons who not only demonstrated exceptional surgical expertise but also showed profound compassion and dedication to their patients. Their guidance and encouragement were instrumental in shaping my career path and solidifying my commitment to cardiothoracic surgery.
ACR: Could you provide a brief overview of the current publications on innovative techniques for chest wall reconstruction? Are there any examples that stood out to you?
Dr. Gritsiuta: Certainly. The field of chest wall reconstruction has seen significant advancements in recent years, driven by the need to address complex defects resulting from oncologic resections, trauma, infections, and congenital conditions. One of the most notable innovations is the use of 3D-printed custom implants. Recent publications have highlighted the successful application of these implants, which are designed based on patient-specific anatomy using advanced imaging techniques. These custom implants offer excellent anatomical fit, stability, and cosmetic outcomes. The use of biologic meshes, such as acellular dermal matrices, has gained popularity in chest wall reconstruction. These materials promote tissue integration and reduce the risk of infection compared to synthetic meshes. Recent clinical trials and case series have reported positive outcomes with biologic meshes, particularly in complex reconstructions where there is a high risk of contamination. Advances in microsurgical techniques have enhanced the use of flap reconstruction for chest wall defects. The incorporation of muscle and myocutaneous flaps, such as the latissimus dorsi and rectus abdominis flaps, has been extensively documented. Innovations in flap design and vascular anastomosis have improved the versatility and success rates of these procedures. Hybrid approaches that combine different reconstruction techniques are emerging as a promising strategy for managing complex chest wall defects. For instance, the combination of rigid prosthetic materials with soft tissue flaps can provide both structural support and adequate soft tissue coverage. These advancements are improving the outcomes for patients with complex chest wall defects, offering better structural integrity, reduced complications, and enhanced cosmetic results
ACR: How do you approach the integration of new materials and technologies in reconstructive surgery, especially in the context of your research on chest wall reconstruction?
Dr. Gritsiuta: Integrating new materials and technologies in reconstructive surgery, particularly for chest wall reconstruction, requires a multifaceted approach that balances innovation with patient safety and clinical efficacy. My approach begins with a thorough review of the current literature, including peer-reviewed journals, clinical trials, and meta-analyses, to understand the benefits and potential risks associated with new materials and technologies. Adhering to established clinical guidelines and standards set by professional organizations ensures that the integration is grounded in best practices. Collaboration with a multidisciplinary team, including oncologists, radiologists, plastic surgeons, and biomedical engineers, provides a holistic perspective on the feasibility and application of new technologies. Engaging with mentors and peers who have experience with specific materials or techniques also offers valuable insights and practical advice. Every patient’s case is unique, so I conduct individualized assessments to determine the suitability of new materials or technologies based on their specific needs, anatomy, and medical history. Ensuring that patients are fully informed about the benefits, risks, and alternatives of new interventions is crucial for shared decision-making and obtaining informed consent. Ensuring that the adoption of new materials and technologies is ethically sound and prioritizes patient welfare is paramount. Evaluating the cost-effectiveness of new interventions is also important, ensuring that they provide value and are accessible to patients. By adhering to this structured approach, I strive to ensure that the integration of new materials and technologies in chest wall reconstruction is both innovative and safe, ultimately enhancing patient outcomes and advancing the field of reconstructive surgery.
ACR: Are there any emerging trends or technologies in thoracic surgery that you find particularly promising or that you are currently investigating?
Dr. Gritsiuta: Single-port robotic surgery is an exciting and rapidly advancing area within thoracic surgery that holds considerable promise for the field. This innovative technique involves the use of a robotic system to perform complex surgical procedures through a single incision, typically less than 3 cm in size. Unlike traditional multi-port robotic surgery, which requires multiple incisions, single-port technique aims to minimize the physical trauma associated with surgical access. One of the primary benefits is its potential to significantly reduce postoperative pain and scarring, as well as shorten recovery times for patients. By using a single entry point, the procedure minimizes the disruption to surrounding tissues, leading to a quicker and more comfortable recovery process. This minimally invasive approach is particularly beneficial for patients who might be at higher risk for complications with traditional open surgery or even multi-port video-assisted thoracic surgery (VATS). The technological advancements driving single-port robotic surgery include highly sophisticated robotic platforms equipped with flexible, articulated instruments and high-definition 3D visualization. These systems provide surgeons with enhanced precision and control, allowing for intricate maneuvers within confined anatomical spaces. The improved dexterity and visualization capabilities of these robotic systems enable surgeons to perform complex thoracic procedures, such as lobectomies and segmentectomies, with greater accuracy and efficiency. Current research and clinical trials are focused on expanding the applications of single-port robotic surgery and refining the technology further. Ongoing developments aim to enhance the versatility and functionality of robotic instruments, improve the user interface, and integrate advanced imaging technologies for better intraoperative guidance. As the technology continues to evolve, it is expected that single-port robotic surgery will become increasingly prevalent in thoracic surgery, offering a less invasive alternative with numerous benefits for both patients and surgeons.
ACR: What are the next steps in your research, and are there any specific areas within cardiothoracic surgery that you are particularly eager to explore further?
Dr. Gritsiuta: As part of my ongoing research efforts, I am focusing on the critical issue of anastomotic leaks following esophagectomy and exploring strategies to improve patient outcomes. This area is particularly significant given the high morbidity and mortality associated with such complications. Exploring new surgical technologies, such as real-time intraoperative imaging and robotic-assisted surgery, can enhance precision and reduce the risk of leaks.
ACR: Reflecting on your career so far, what has been the most rewarding experience, and how has it shaped your outlook on surgery and research?
Dr. Gritsiuta: The most rewarding experience has been the direct impact of patient care. The opportunity to help patients through challenging times and witness their recovery and improvement has been incredibly fulfilling. Each patient’s journey, from the initial consultation to the post-operative follow-ups, has reinforced the profound difference that compassionate and skilled surgical care can make in someone's life. This focus on patient care has profoundly shaped my outlook on surgery and research. It has instilled in me a deep commitment to ensuring that every patient receives personalized and empathetic care, tailored to their unique needs and circumstances. The privilege of making a tangible difference in patients' lives drives my passion for both clinical practice and ongoing research. It is this daily impact on patient well-being that motivates me to strive for excellence in every aspect of my work.
ACR: How has your experience been as an Editorial Board Member of ACR?
Dr. Gritsiuta: It has been both enriching and professionally rewarding. Serving in this capacity has provided me with a unique vantage point to observe and contribute to developments in clinical research and surgery. Furthermore, being involved in the editorial process has sharpened my critical thinking and analytical skills. It has also kept me abreast of the latest innovations and trends in the surgical field, which I can integrate into my practice to improve patient outcomes. Overall, my tenure with the ACR has been a significant professional milestone, enriching my career and enhancing my contributions to the medical community.
ACR: As an Editorial Board Member, what are your expectations for ACR?
Dr. Gritsiuta: As an Editorial Board Member, I have several key expectations that I believe are essential for maintaining the journal's high standards and advancing its impact in the field of clinical research. I expect ACR to uphold the highest standards of scientific rigor in the selection and review of manuscripts. This includes thorough peer review processes that ensure the validity, reliability, and originality of the research published. I expect the journal to foster an environment of interdisciplinary collaboration, encouraging submissions that integrate insights from various medical and scientific disciplines. This approach can lead to more comprehensive and holistic advancements in healthcare. I expect ACR to enforce policies that ensure the integrity of the research, including transparency in conflicts of interest and adherence to publication ethics. Finally, I expect ACR to embrace continuous improvement, regularly updating its processes, technologies, and methodologies to stay current with the evolving landscape of clinical research and publishing. By meeting these expectations, ACR can continue to be a leading platform for disseminating valuable clinical research that advances the field of medicine and improves patient outcomes.