**5. Conclusion**

Recent advances in surgical instruments and technique allows surgeons to perform OPCAB safely.

OPCAB for left main disease and multivessel revascularization is no longer a contraindication.

Except for patient undergoing redo CABG, hemodynamically compromised patients, and patient with poor target vessels, OPCAB can be performed by an experienced surgeon without increasing risks.

OPCAB requires a significant intensive training period.

OPCAB may expand the indications of CABG to patients with higher risks.

OPCAB contributes to shortening the length of stay and promotes an early recovery.

Table 3. Summary of the advantages and disadvantages of OPCAB

Although there is a steep learning curve for OPCAB techniques, OPCAB provides a favorable or at least equivalent postoperative outcome compared to on-pump CABG, with minimal contraindications. OPCAB will significantly reduce the risk of CPB-related complications. These benefits of OPCAB are more significant in high-risk patients, and there is a possibility to expand the indication of CABG.
