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Updated: Mar 23, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
The Value of Robotic-Assisted Combined Left Renal Vein and Proximal Gonadal Vein Transposition for Nutcracker
Hua Wang1, Jinbin Xu1, Qunxiong Huang1
1Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Background:
This study compares outcomes of robotic Robotic-assisted left renal vein (LRV) transposition with and without proximal left gonadal vein (LGV) transposition for Nutcracker Syndrome (NCS).
Methods:
A retrospective analysis was conducted on 24 NCS patients. Group A (n = 13) had LRV transposition. Group B (n = 11) had combined LRV+ proximal LGV transposition. Outcomes including operative details, complications, symptom resolution, and renocaval pressure gradient (RPG) reduction.
Results:
Operative time and hospital stay were similar between the groups. However, group B had a higher lymphatic leakage rate (64% vs. 8%; p = 0.0078) and required longer drainage (median 5 vs. 3 days; p = 0.02). Clinical symptoms improved in both groups. Group B achieved substantially greater RPG reduction (70% ± 15% vs. 55% ± 8%; p = 0.004).
Conclusions:
Robotic LRV and proximal LGV transposition for significant dilation is safe and effective. Despite higher short-term lymphatic morbidity, the combined approach offers greater reduction in RPG, providing a valuable alternative for selected patients.
Trial Registration:
This research was also registered at the Chinese Clinical Trial Registry. The registration number is ChiCTR2500099335 (Link: https://www.chictr.org.cn/bin/project/edit?pid=261879).
