Layer-Oriented Lateral Superior Approach for Robotic Right Hemicolectomy: A Novel Embryology-Based Strategy and Initial Clinical Outcomes
- 1Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya, Izumo 693-8501, Shimane, Japan
Abstract
Background: Complete mesocolic excision (CME) with D3 lymphadenectomy is an oncologically established procedure for right-sided colon cancer; however, the optimal dissection plane and surgical approach remain controversial. We developed a novel layer-oriented lateral superior approach (LSA) that enables the intentional, depth-tailored selection of embryological dissection planes in robotic right hemicolectomy. Methods: This retrospective single-center study included consecutive patients who underwent robotic right hemicolectomy using the LSA between June 2023 and May 2025. The dissection plane was selected according to tumor depth (≤T2 vs. ≥T3). Perioperative and short-term oncological outcomes were evaluated. Results: Thirty-six patients were included. The median operative time was 289 min, and the median blood loss was 10 mL. No intraoperative complications or conversions occurred. Postoperative complications were observed in 6 patients (16.7%), all ≤Clavien–Dindo grade II. The median number of harvested lymph nodes was 31, and main lymph node metastases around the middle colic artery were identified in three patients. Among patients who underwent curative-intent resection (stage I–III), the median follow-up was 16.9 months. The estimated 2-year disease-free and overall survival rates were 92.4% and 84.2%, respectively. Conclusions: The LSA was feasible and safe in this initial series and provides a novel layer-oriented strategy for robotic CME.
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BibTeX
@article{yamamoto2026layeroriented,
title = {{Layer-Oriented Lateral Superior Approach for Robotic Right Hemicolectomy: A Novel Embryology-Based Strategy and Initial Clinical Outcomes}},
author = {Tetsu Yamamoto and Takahito Taniura and Kazunari Ishitobi and Keisuke Inoue and Shunsuke Kaji and Takayuki Tanaka and Takeshi Matsubara and Masaaki Hidaka},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208016},
url = {https://www.mdpi.com/2077-0383/15/20/8016},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Layer-Oriented Lateral Superior Approach for Robotic Right Hemicolectomy: A Novel Embryology-Based Strategy and Initial Clinical Outcomes
AU - Tetsu Yamamoto
AU - Takahito Taniura
AU - Kazunari Ishitobi
AU - Keisuke Inoue
AU - Shunsuke Kaji
AU - Takayuki Tanaka
AU - Takeshi Matsubara
AU - Masaaki Hidaka
PY - 2026
DA - 2026/10/16
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208016
UR - https://www.mdpi.com/2077-0383/15/20/8016
AB - Background: Complete mesocolic excision (CME) with D3 lymphadenectomy is an oncologically established procedure for right-sided colon cancer; however, the optimal dissection plane and surgical approach remain controversial. We developed a novel layer-oriented lateral superior approach (LSA) that enables the intentional, depth-tailored selection of embryological dissection planes in robotic right hemicolectomy. Methods: This retrospective single-center study included consecutive patients who underwent robotic right hemicolectomy using the LSA between June 2023 and May 2025. The dissection plane was selected according to tumor depth (≤T2 vs. ≥T3). Perioperative and short-term oncological outcomes were evaluated. Results: Thirty-six patients were included. The median operative time was 289 min, and the median blood loss was 10 mL. No intraoperative complications or conversions occurred. Postoperative complications were observed in 6 patients (16.7%), all ≤Clavien–Dindo grade II. The median number of harvested lymph nodes was 31, and main lymph node metastases around the middle colic artery were identified in three patients. Among patients who underwent curative-intent resection (stage I–III), the median follow-up was 16.9 months. The estimated 2-year disease-free and overall survival rates were 92.4% and 84.2%, respectively. Conclusions: The LSA was feasible and safe in this initial series and provides a novel layer-oriented strategy for robotic CME.
SN - 2077-0383
ER -