A 78-year old female 3cm size right renal artery aneurysm. Totally minimally invasive treatment with the 4th arm DaVinci system. Microdissection of the proximal artery and of the two efferent branches harvesting of safenous vein with preparation of a Y-loop (Bench surgery). Endoscopic microclamping. Aneurismectomy. Microsurgical reconstruction with the safenous loop (PTFE 7/0) 30 warm Ischaemia. Perfect long term renal function.