This dictum pervaded surgery for decades. The explosive success of laparoscopic procedures served as a stimulus for seeking smaller windows of access to other body cavities and structures. Old techniques were resurrected, and new technologies were developed as interest surged from both physicians and patients to become minimally invasive. The field of cardiac surgery was not immune to this wave of interest in radically shrinking the size of incisions. Cardiac surgery, particularly coronary artery bypass grafting (CABG), had reached an unparalleled level of success, reliability, and acceptance through the thoughtful blending of cardiopulmonary bypass (CPB) technology, cardioplegic-induced cardiac arrest, enhanced surgical techniques, sophisticated postoperative care, and experience. However, the time was ripe for reassessing what had become the standard approach to surgical revascularization of the heart. The search was begun to seek improvements in the standard CABG operation, which included downsizing the length of the incisions.