performing a bypass surgery through a small cut on the chest wall requires skill and mindset to execute the operation in a systematic and successful way without causing much trauma to the tissues around and without risking the outcome of the procedure. I have detailed the procedure here with usual instruments (except the mammary retractor which you may not need if only vein grafts are used) that are used in midline sternotomy with successful outcome. All it needs is a mindset to get started somewhere and I guess, with time, the surgeon will find the right technique much to the appreciation of the patient.
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