One of the many problems that evades resolution is that of combining elective abdominal aortic reconstruction with simultaneous gastrointestinal intervention, even in a prepared bowel. The article by Dr Luebke et al attempts answer in their series of 84 patients, half of whom underwent aortic grafting and a simultaneous operation for gastrointestinal abnormalities. Comparing the matched pairs revealed no significant difference as to morbidity, mortality, or length of intensive care unit and hospital stays. They conclude that a 1-stage procedure is feasible, presuming appropriate attention to details and antisepsis. In an invited critique, Dr Quiñones-Baldrich presents a balancing opinion of the work and Dr Bredenberg some other thoughts.