Robotic CME vs laparoscopic right-sided hemicolectomy: first year experiences, complications and stage migration

Abstract Introduction Complete mesocolic excision (CME) for right sided colon cancer includes D3 lymphadenectomy with an increased lymph node yield compared with standard laparoscopic right-sided hemicolectomy. Both robotic surgery and robotic CME were implemented at Ersta hospital in May 2024. The aim was to describe the initial experiences with focus on short term complications and pathological results. Method Retrospective cohort study of all consecutive colon cancer patients operated with right-sided colon resection from May 2024 to April 2025. Patients were operated with robotic CME if available, and otherwise with standard laparoscopic right-sided hemicolectomy (lap group). No patient selection was made regarding surgical method. Data were compared between the groups. Result 22 robotic CME (first three procedures with proctor excluded) and 21 laparoscopic right-sided hemicolectomies were performed. There were no conversions to open surgery in the CME group and three in the lap group. One patient in each group had a complication (CD>2) with reoperation due to small bowel obstruction. PT4 stage was more common in the CME group (8 of 22 (36%) vs 1 of 21 (5%), p=0.01) and more lymph nodes were examined (33 vs 22) compared with the lap group. Pathological TN stage was higher than clinical TN stage in 54 and 50% of the patients in the CME and lap groups. Discussion CME was safe with no conversions to open surgery. Radiological understaging was high in both CME and lap groups. The increased lymph node yield in CME patients may be clinically important for radical surgery, correct staging, and adjuvant oncological treatment.