Abstract
Transperitoneal and traditional retroperitoneal approaches through a flank incision both have advantages and disadvantages. This report suggests a third approach, a retroperitoneal aortobifemoral bypass through a midline abdominal incision. This approach carries benefits of both approaches in select patients with infrarenal aortoiliac occlusive disease. In this innovative technique, a patient with rest pain and wound with aortoiliac occlusive disease is treated through a midline retroperitoneal approach.