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.