Purpose of review Minimally invasive techniques are being developed at a rapid rate, although not all of these stand up to close peer-review and scrutiny. We describe the current state of laparoscopy and robotic-assisted reconstructive urological surgery on the lower urinary tract. These procedures are technically demanding and require advanced laparoscopic skills, including suturing. Recent findings Techniques for urethra-vesical anastomosis following radical prostatectomy and reconstruction after radical cystectomy are discussed. In addition, minimally invasive techniques for bladder augmentation, colposuspension and ureteric reimplantation are reviewed. Summary We indicate both the reconstructive procedures supported by sound evidence and those with little hard data backing them up.