The operating time of multiple rib resections for the purpose of collapsing the chest wall in the treatment of pulmonary tuberculosis or chronic pulmonary suppuration should be reduced to the minimum consistent with thoroughness.
The most time-consuming part of a thoracoplasty is preparing the rib for subperiosteal resection. It follows that the fewer the instruments required and the fewer necessary manipulations of them, the quicker the act will be accomplished.
Separation of the periosteum from the outer flat surface of the rib with the usual periosteal elevator or gauze sponge is as a rule rapidly done. But separating the periosteum along the inner surface and at the upper and lower borders of the rib at the attachments of the intercostal muscles is tedious, particularly if there has been some periostitis secondary to pleurisy.
The Doyen raspatory is not practical. Because of the varying diameter of
Matson RC. A RIB PERIOSTEAL STRIPPER AND RASPATORY FOR EXTRAPLEURAL THORACOPLASTY. JAMA. 1928;90(24):1944-1945. doi:10.1001/jama.1928.92690510002010c