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Les Tiffany

Image of Les Tiffany, da Vinci surgery patient at EvergreenHealth in Kirkland, WA

Diagnosis:  Gallstones

Treatment:  da Vinci® gallbladder removal

Les Tiffany had been dealing with the occasional abdominal pain for three to four years, but it wasn’t until an acute attack that he went to his primary care provider for answers.

An ultrasound revealed gallstones.

Les would need surgery to remove the gallbladder, and he got a strong recommendation from his longtime primary care provider.

“He recommended Dr. Michael Towbin, who had operated on him,” Les recalls. “He said Dr. Towbin was the guy I needed to see.”


Les' primary care provider also knew the surgeon had recently begun using the state-of-the-art da Vinci® robotically-assisted surgical system for gallbladder removal.

“While the da Vinci® system is renowned for prostate and gynecologic surgeries,” Dr. Towbin explains, “ it’s relatively new in the general surgery arena."

So Dr. Towbin began adapting the da Vinci® for use in surgeries such as gallbladder removal.

He says the da Vinci® offers several advantages, starting with the ergonomics.

“The wrist controls can do more than the human wrist, which means you can get different angles and approaches to anatomy,” he explains. “And the high-definition camera gives us 3-D images for incredible accuracy.”

The da Vinci® also gives the surgeon four “arms” to control the operation instead of the two arms provided by the current surgical standard of laparoscopic gallbladder removal.

“That provides a higher level of precision,” he adds. “I’ve done a number of surgeries where I wouldn’t have been able to use a minimally invasive procedure without the da Vinci®.”

For patients, this means less blood loss, less pain and a faster recovery.

Les was able to go home the same day as his surgery, and he didn’t even have to take a pain pill.

“Because of the precision of the robotic-assisted system, it knows where each access point is, so there’s no movement of the abdominal wall or tension on the abdominal wall,” Dr. Towbin details. “So without that stretching, there’s very little pain.”


Les Tiffany’s surgery at EvergreenHealth marked the first time in the nation that the da Vinci® had been used for gallbladder removal, but he wasn’t as impressed by that milestone as he was by the fact that he went home the same day and needed no pain medication.

“There were just five tiny incisions,” Les shares. “I remember sleeping through the night when I got home. I didn’t spend any time lying around in bed, I was pretty mobile. I felt like I could easily have done just about anything that didn’t risk tearing the incisions.”

Like most people, Les was feeling pretty anxious going into the surgery, but he credits Dr. Towbin with doing a great job explaining the surgery and the advantages of the da Vinci® robotic-assisted procedure.

“I also went online to research gallbladder removal surgery using the robotic techniques, so I felt very informed,” Les adds. “Everything turned out great. I would have loved to have stayed awake to watch, but that wasn’t an option.”


As for the future? Dr. Towbin predicts the da Vinci® will revolutionize general surgery.

Thanks to the da Vinci®’s training and simulators, Dr. Towbin is able to practice and perfect new techniques and approaches for the many general surgeries that make up his practice.

He’s already using the da Vinci® to perform minimally invasive surgeries in difficult cases in which, previously, a large-incision “open” surgery might have been the only option.  

Dr. Towbin was also the first in the Washington-Oregon region to perform minimally invasive gallbladder removal using just a single incision in the patient’s belly button. 

“A minimally invasive surgery through a single incision is virtually impossible without the da Vinci® robot,” Dr. Towbin adds. “I’ve been a surgeon for many years, and I’ve not been this excited about a surgical tool. This is a game changer; it really is.”

In response to growing demand from both patients and surgeons, da Vinci® options are available for colorectal, gynecological, urogynecological, prostate, oncological and bariatric surgeries. More than a dozen of EvergreenHealth’s surgeons are trained on them, supported by a specialized robotics team in the operating room.

For EvergreenHealth, it’s just another exciting technology that, combined with the skill of our highly trained medical staff, allows us to provide our patients with a safer outpatient procedure with significantly reduced recovery times.

Honored to be a recognized national leader in Surgical Services

Image of Healthgrades Excellence award for general surgery

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