The most effective treatment for some stage T2 and T3 bladder tumors is still radical total cystectomy, and the problem of urinary diversion is inevitable after total cystectomy. A good urinary diversion should be as physiological as possible, effectively protect renal function, facilitate patients, and improve quality of life, and the urinary diversion procedure has been innovated and improved in recent years. Currently, the commonly used urinary tract reconstruction is divided into non-controllable urinary flow diversion and controlled urinary flow diversion according to whether the output tract urine can be controlled. Non-controllable urinary diversion: there are mainly two types of ureteral ventral wall stoma and ileal cystectomy. The former procedure is simple, safe, has little impact on bowel function, and has a quick recovery, but postoperative complications such as urinary leakage and retrograde infection are common. Ileocecal cystectomy has smooth urine drainage, maintains the function of the upper urinary tract, less affects the water-electrolyte balance, good compliance with the use of the stoma bag, and the procedure is easy to master, so it is still the mainstream of urinary tract reconstruction, but it requires long-term hanging of urine bags, poor quality of life, and many complications and other disadvantages. There are various ways of controlled urinary diversion, including controlled ileal bladder, Sigma rectal bladder, orthotopic controlled sigmoid spherical bladder, etc. However, these controlled bladder procedures are complicated, with unstable results and more complications, and are not in the mainstream of urinary diversion. In situ neobladder is also one of the modalities of controlled urinary diversion, and there is a trend towards cystoplasty with ileal detubulation or sigmoid detubation. The ability to urinate normally from the original urethra has less impact on life and work, and some patients can have their sexual function preserved with significantly fewer complications. It is especially advantageous that this procedure can be accomplished through the laparoscopic surgical route with little injury and quick recovery, and we have now successfully performed several cases of laparoscopic in situ neobladder surgery with good results. Throughout the development of urinary tract reconstruction, the creation of a near normal urinary storage neobladder (low pressure, high volume, no reflux), which can naturally urinate and control urine via the original urethra. Conformity to physiological characteristics and the ability to ensure a high quality of life are goals that urologists continue to pursue with innovation.