stepwise approach, starting with the adoption of the ministernotomy technique as routine. We then transitioned to the right minithoracotomy approach, first under direct view, then with an endoscopic camera,
DISCUSSION In our institution, moving toward a less invasive technique has required a stepwise approach, starting with the adoption of the ministernotomy technique as routine. We then transitioned to the right minithoracotomy approach, first under direct view, then with an endoscopic camera,