The Value of Robotic‐Assisted Combined Left Renal Vein and Proximal Gonadal Vein Transposition for Nutcracker Syndrome: Preliminary Experience From a Single Centre

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 )