Robotic versus laparoscopic surgery for right-sided colon cancer: is it better for central lymph nodes harvesting in right colectomy with complete mesocolic excision?

BACKGROUND: The purpose of this study is to compare the total number of central lymph nodes harvested among right-sided colon cancer (RCC) patients who underwent complete mesocolic excision (CME)-right colectomy with robotic and laparoscopic techniques. METHODS: A consecutive series of patients who underwent elective right colectomy for right colon cancer utilizing either laparoscopy or robotic techniques between January 2018 and December 2025. The number and distribution of apical lymph nodes identified in the final pathology reports were assessed and compared between the two groups. RESULTS: Robotic CME was associated with a significantly higher total lymph nodes yield (33.5 vs. 29.1; p = 0.013) and superior apical nodes harvest (11.7 vs. 7.8; p < 0.001) compared to laparoscopic CME. Specifically, the robotic approach yielded more nodes at the right superior colic vein (2.2 vs. 1.0; p = 0.006) and the right branch of the middle colic artery (2.5 vs. 1.8; p = 0.018). While RRC had longer operative times (256.5 vs. 229.9 min; p < 0.001), it was associated with a significantly shorter length of stay (5.0 vs. 6.5 days; p < 0.001) and faster recovery of bowel function (p < 0.001). CONCLUSION: Robotic CME for RCC allows for more extensive central lymphadenectomy than laparoscopy, particularly at critical vascular origins. Combined with enhanced functional recovery and reduced morbidity, these findings support the adoption of robotic technology for CME resections.