Evergreen Begins Using Sophisticated Robotics for Gall Bladder Surgeries

A surgeon at Kirkland’s has become one of the first in the region to use a state-of-the-art robotic device to perform a minimally invasive gall bladder removal through the navel.

Dr. Michael Towbin on March 20 began using a da Vinci Surgical System, a computerized robotics platform made by Intuitive Surgical Inc., to remove gall bladders.

“The precision is unbelievable,” he said. “The patients have no large incision. It’s inside the belly button, so you don’t really see anything. It’s a platform that will be utilized for more targeted surgeries.”

The system, very much futuristic in appearance, is a form of endoscopic surgery in which a thin tube with lighted optics is inserted into the abdomen. The da Vinci is also equipped with thin, "wristed" instruments. The surgeon sits at a console a few feet away, commanding a two-armed robotic device with twin hand controls, watching the operation through an HD/3-D imaging mask.

“It’s an application with a robot/computer interface,” Towbin said last week before prepping for a surgery. “The entire operation is done inside the abdomen. It’s technically complex. The imaging is superlative. The information in your face is wonderful.”

Towbin was the first to use the da Vinci system to remove a gall bladder in Oregon and Washington, although University of Washington surgeons have performed the same operation with other robotics platforms.

In the past, gall bladder removal required more than one incision through the abdomen, and the patient might remain in the hospital most of the day or even overnight. With the robotics platform, the operation is performed and the patient is headed home within several hours.

The first two patients were a 66-year-old man and a 33-year old woman. They reported “no problems, not much pain,” said Towbin, a surgeon at Evergreen since 1989 and a Kirkland resident. “It’s slick.”

The robot can actually remove the gall bladder, which ranges in size from an inch to several inches, through the navel, by bagging it and draining its fluids.

“It’s a big tool in the toolbox of a surgeon,” Towbin said.

The gall bladder is a pear-shaped organ on the upper-right side of the abdomen that sits just below the liver. It stores bile, a digestive fluid produced in the liver, and is often removed to relieve the pain and discomfort of gallstones.

Evergreen has used the da Vinci robot for other operations for two years now, and due to its success recently added a second one.

Evergreen last week also became one of the first in the region to use a state-of-the-art endoscopic camera navigation system to perform minimally invasive spine surgery.

Dr. Jeffrey Roh used the technology March 26 in a Transforaminal Lumbar Interbody Fusion (TLIF) procedure, removing a disc from between two vertebrae and then fusing them back together.

Developed by the medical technology company Stryker, the system allows surgeons to use scans of a patient's anatomy for enhanced visualization, and allows the surgeon to track the exact position of surgical instruments through the system’s camera. That allows more precise placement of metal fasteners, among other benefits.