Single-incision robotic complete mesocolic excision for right-sided colon neoplasms: technical and oncologic feasibility

Background: Single-incision robotic surgery (SIRS) using the da Vinci SP system (dVSP) offers advantages such as improved cosmesis, reduced invasiveness, and technical precision in colorectal surgery. However, real-world data regarding the technical feasibility and oncologic outcomes of dVSP-based complete mesocolic excision (CME) with central vascular ligation (CVL) for right-sided colon neoplasms remain limited. Methods: We retrospectively reviewed the medical records of patients who underwent single-incision robotic right colectomy for colon cancer or precancerous lesions with dVSP between July 2019 and April 2025. Demographic characteristics, perioperative outcomes, pathologic results, and survival outcomes were analyzed. Results: Fifty-two patients were included. Mean operation time and estimated blood loss were 282.2 ± 54.5 min and 65.9 ± 44.9 ml, respectively. Intracorporeal anastomosis was performed in 67.3% of cases, and the mean umbilical wound length was 3.7 ± 0.9 cm. There were no conversions to open surgery or intraoperative complications. The mean time to first flatus was 2.6 ± 0.7 days, and patients began a soft diet at 3.2 ± 0.6 days postoperatively, with a mean hospital stay of 7.0 ± 2.4 days. Postoperative complications occurred in 19.2% and readmission rate was 5.8%. Pathologic outcomes showed 23.9% of patients with stage III disease, the mean number of harvested lymph nodes was 45.5 ± 25.0, and all cases had negative resection margins. One patient (1.9%) developed local recurrence at 8 months postoperatively, resulting in disease-specific mortality, and another patient (1.9%) developed multiple lung metastases at 9 months and is currently receiving palliative chemotherapy. Among patients with malignant tumors, 5-year overall survival and disease-free survival rates were 93.3% and 93.7%, respectively. The median follow-up period was 30.0 (range 5.0–72.0) months. Conclusion: Single-incision robotic right colectomy using the dVSP is technically feasible and safe approach, offering favorable perioperative results and has proven oncologic safety based on long-term outcomes.