In a challenging multidisciplinary surgical undertaking, a team of surgeons in Tirunelveli, Tamil Nadu, successfully performed coronary artery bypass grafting (CABG) followed immediately by laparoscopic abdominal surgery in a 75-year-old man. Both procedures were completed during the same surgical session without an intervening recovery period, an approach reported in only a handful of cases worldwide. The patient had triple-vessel coronary artery disease and a 10-cm mesenteric cyst that was causing severe abdominal pain.

Given the need to address both conditions, the team opted for a combined surgical approach rather than delaying the abdominal intervention until after cardiac recovery. The cardiac team first performed off-pump CABG, creating three bypass grafts to restore blood flow to the heart. An internal thoracic artery graft and two saphenous vein grafts were used to bypass the…