The orthotopic bladder replacement (neobladders) has become an established method for urinary diversion after cystoprostatectomy for bladder cancer. Most neobladders are con-structed from detublarized ileum, colon, or both, but all types reabsorb chloride and precipitate acidosis in patients with borderline renal function. This videotape illustrates the construction of a neobladder using a stomach patch based on the right epiploic artery. The urinary reservoir is spherical and is especially suited for patients with borderline renal function because it does not absorb chloride.