Transabdominal mimially invasive direct coronary artery bypass grafting (MIDCAB).

The major limitations of current minimally invasive direct coronary artery bypass (MIDCAB) techniques are multivessel and distal vessel disease frequently seen in patients with extensive stent restenosis ('full metal jacket syndrome') and reoperative surgery. Two separate minimal access incisions (minithoracotomy, lower partial sternotomy) have been used to bypass two separate arteries (left internal mammary artery (LIMA) to left anterior descending (LAD), right gastroepiploic artery (RGEA) to posterior descending artery (PDA)). To bypass multiple coronary arteries using multiple arterial conduits without violation of bony parts, we use a new minimal access incision by 'transabdominal approach'.