Miller School Urologist Wins Debate at 30th World Congress

Raymond J. Leveillee, M.D., professor of urology and Chief of the Division of Endourology, Laparoscopy and Minimally Invasive Surgery, defeated University of Texas Southwestern’s Jeffrey A. Cadeddu, M.D., in a debate on Laparoendoscopic Single Site Surgery (LESS) at the 30th World Congress of Endourology and SWL in Istanbul, Turkey.

The September 6 debate weighed arguments for and against LESS.

According to Leveillee, the procedure focuses more on aesthetics than patient safety. Recent studies show LESS is associated with a higher risk of complications.

“With all things being equal, it would be counter-intuitive to subject patients to higher risks just to prevent a couple more keyhole incisions,” said Leveillee.

The technique also imposes ergonomic challenges that contribute to surgeon fatigue, the main cause of technical errors and cloudy judgment during surgery.

Leveillee says with the right technology, LESS holds a lot of promise, but not until the appropriate instruments are developed.

Currently, many LESS procedures are conducted using an extra 3 millimeter puncture to introduce a dissector instrument to aid in the surgery.

“These hybrid LESS surgeries are actually conventional laparoscopic surgeries disguised as LESS by using ‘cheat’ ports,” says Leveillee.

“LESS is not yet ready for primetime,” he told the congress.

Leveillee was accompanied by UM visiting research scholar Arturo Castro, M.D., a urologist from the Philippines and recipient of the International Fellowship Award from the Endourological Society, which allowed him to study under Leveillee for a year. Castro presented a paper and video detailing the Miller School’s use of the Single Port Instrument Delivery Extended Reach, or SPIDER, surgical system in a LESS laparoscopic cyst decortication. The Miller School is one of only two centers to use the novel device.

Recently granted tenure, the highest recognition bestowed upon faculty for scholarly academic accomplishments, Leveillee is an internationally known authority on minimally invasive surgery. He is also President-elect of the Southeastern Section of the American Urological Association and founding director of UM’s Joint Bioengineering and Endourology Surgical Developmental Laboratory (JBEDS), which primarily advances the design and testing of needle ablative modalities, as well as the development of other emerging technologies that can enhance minimally invasive surgery.

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