In selected cases of recurrent renal calculi, surgery to facilitate the passage of stones from the kidney is required. Surgical techniques designed to fulfill these requirements have included the creation of substitute wide-bore ureter from bowel (ileal interposition) or from the urinary bladder (Boari-Ockerblad bladder flap), the latter usually requiring renal autotransplantation to the ipsilateral or contralateral pelvis. The clinical circumstances in which such surgical procedures are warranted are discussed, as are details of operative technique.