Visceral Fat Area Influences Lymph Node Retrieval in Robotic Right Colectomy
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Updated: Sep 21, 2026
Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
Published on: January 9, 2026
Masatsugu Ishii1, Toshikatsu Nitta1, Akitada Sada1
1Division of Surgery, Gastroenterological Center, Medico Shunju Shiroyama Hospital, Habikino, Japan.
Background And Objectives:
Visceral obesity may affect surgical difficulty in colorectal procedures. While body mass index (BMI) is commonly used to assess obesity, it does not accurately reflect intra-abdominal fat distribution. This study evaluated the impact of visceral fat area (VFA) on perioperative outcomes in robotic-assisted right colectomy.
Methods:
We retrospectively analyzed consecutive patients undergoing robotic-assisted right colectomy with lymphadenectomy between January 2023 and May 2025. VFA was measured on preoperative computed tomography at the L4 level. Patients were categorized into low-VFA (<100 cm2) and high-VFA (≥100 cm2) groups. Surgical outcomes and lymph node yield were compared.
Results:
Sixty-one patients were included, and 29 (47.5%) were classified as high VFA. Lymph node yield was significantly lower in the high-VFA group (P < .001). Operative time, blood loss, and postoperative complications did not differ significantly between groups. Major complications occurred in 6.5% of patients.
Conclusion:
Visceral adiposity is associated with reduced lymph node retrieval in robotic-assisted right colectomy, without increasing perioperative morbidity. VFA may serve as a practical indicator of operative complexity.
