CME right colectomy with D3 lymphadenectomy for colon cancer through a bottom-to-up approach using CMR versius robotic system: an IDEAL stage 1 report.

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.