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A rib spreader is a type of retractor specifically designed to separate ribs in thoracic surgery. Rack-and-pinion-type stainless steel rib spreaders (with a thumb-screw to lock it in place) were an innovation introduced by French surgeon Theodore Truffier in 1914. This was modified in 1936 by Argentinian surgeon Enrique Finochietto to have fenestrated blades (blades with "windows") and a hand-cranked lever to both separate the arms in a staged fashion and lock them in place at each stop. The Burford-Finochietto rib speader has replaceable blades. The Truffier and especially the Burford-Finochietto (and its variants) are ubiquitous in open thoracic surgery, which accounts for over 90% of thoracic surgeries. Minimally invasive thoracic techniques (such as VATS and teleoperated surgical machines) have yet to prove superior, despite decades of development.