Panpleuropneumonectomy, resection of a huge tumor in the thorax or operation of thoracic aneurysm requires good view of the entire thorax. Two separate incisions of lateral thoracotomy would not usually provide a sufficient operative field. The procedure of rib cross thoracotomy is as follows: The 6th, 7th, 8th, 9th rib with the intercostal muscle and vessels are cut at mid axillary line and removed 1 cm length at each edge of the ribs. The posterior half of the 6th ribs is removed. Thorax is entered posterioly at the 5th intercostal space and caudally to the 9th rib at the axillary line and anteriorly at the same intercostal space. Two rib expanders are needed.