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Updated: Aug 21, 2026

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
Published on: January 9, 2026
CME right colectomy with D3 lymphadenectomy for colon cancer through a bottom-to-up approach using CMR versius
Corrado Pedrazzani1,2, Ernesto De Giulio3,4, Giulia Turri3
1Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust, Piazzale Ludovico Scuro 10, 37134, Verona, Italy. corrado.pedrazzani@unitn.it.
Abstract:
New robotic platforms are entering clinical practice, necessitating standardisation of surgical technique. This study presents the first case series (IDEAL Stage 1) of bottom-to-up complete mesocolic excision (CME) right colectomy with D3 lymphadenectomy using the CMR Versius Robotic System. The procedures were conducted as part of the COMPAR trial at Azienda Ospedaliera Universitaria Integrata of Verona. Port set-up and BSU positioning were iteratively refined across cases in accordance with IDEAL Stage 1 methodology. Six patients were enrolled. Technical refinements were introduced after case 3 to optimise traction and exposure. Median operative time was 296 min (range 233-410). No intraoperative complications occurred; one patient required conversion to laparoscopy. All resections were R0 with a median lymph node yield of 27 (range 20-34). This IDEAL Stage 1 report demonstrates the technical feasibility of the bottom-to-up CME approach using the CMR Versius system. Iterative refinements were essential to optimise the procedure; further prospective studies (IDEAL Stages 2-4) are needed to evaluate reproducibility and clinical value.
