A new operative procedure in renal surgery has evolved from the extensive recent experience in kidney transplantation. Bench surgery and autotransplantation have not been, as yet, fully exploited by surgeons caring for children. This approach to reconstruction of renal substance and renal vessels has as its greatest dividend conservation of kidney tissue. The operation has specific applicability for selected cases of: (1) renovascular hypertension; (2) congenital obstructive uropathy; (3) bilateral Wilms' tumor, and; (4) renal trauma in children.