Visceral Fat Area Influences Lymph Node Retrieval in Robotic Right Colectomy.

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.