Surgery at the work bench has developed as a by-product of the extensive experience in renal homotransplantation. A basic tenet of the transplant operation is organ survival outside the human body for a finite period. Recent refinements in kidney preservation have extended the permissible ex vivo period to several days. Consequently, extracorporeal procedures have become highly feasible and a practical adjunct for operative renal surgery. Bench surgery and autotransplantation thus far have been underexploited in pediatric surgery despite potential applicability in a significant number of childhood lesions. At the University of Colorado Medical Center, 14 patients have been treated by extracorporeal renal surgery and have been reported in part.1-3 The purpose of this communication is to review the technical aspects of this new operative procedure, present two case reports, and discuss the potential role of extracorporeal surgery and renal autotransplantation as it pertains to the pediatric patient