Bilateral disease of renal arteries due to renovascular hypertension is encountered, according to the authors' data, in 23% of cases. The standard method of surgical treatment, generally accepted in Russia, consists in staged reconstruction of renal arteries through the thoracophrenolumbotomy approach. For the first time, one stage reconstruction of both renal arteries by type of patch "Gore-Tex" isthmoplasty through laparotomy approach was performed in RRCS RAMS. Technical aspects of the procedures performed in 2 patients are described in details. The authors suggest that one stage reconstruction of both renal arteries through the laparotomy approach is the method of choice in bilateral stenosis of renal arteries and allows to perform not only isthmoplasty but also prosthetic reconstruction of renal arteries up to their bifurcation without intersection of the right renal vein and its branches.