The authors present original operative techniques developed in the Novosibirsk Tuberculosis Research Institute for management of fibro-cavernous pulmonary tuberculosis. These include: a 4-5-rib variant of osteoplastic thoracoplasty as an independent intervention and as a stage followed by pulmonary resection, atypical extrapleural pneumolysis with open tamponade followed by local thoracoplasty. A complex of combined surgical adjuvant procedures comprises extrapleural pneumolysis with open tamponade, dissection of cavernous part of the lung prior to selective thoracoplasty. Indications to the use of the above techniques are provided. Their use in addition to conventional interventions gives one more chance of cure in fibro-cavernous tuberculosis of the lungs.