A medium Finochietto retractor is a self-retaining rib spreader primarily used in thoracic and cardiovascular surgeries to hold ribs apart and provide clear access to the chest cavity. The "4 blade" version is used for more complex or extensive procedures where broader retraction is necessary. 

The medium 4-blade Finochietto retractor is a vital instrument for a range of procedures inside the chest:

Thoracotomy:

As a rib spreader, its fundamental use is to provide surgical access during a thoracotomy (a surgical incision into the chest wall).

Cardiac surgery:

It is often used in open-heart procedures such as coronary artery bypass grafting (CABG) and heart valve replacement. It provides the necessary wide exposure to operate on the heart and surrounding great vessels.

Lung surgery:

The retractor creates a wider working space for procedures involving the lungs, such as lung resections, lobectomies, and pneumonectomies.

Trauma surgery:

It is essential for emergency chest trauma cases, allowing surgeons rapid access to manage injuries to internal organs.

Esophageal surgery:

The device can also be used in surgeries on the esophagus, particularly to repair hiatal hernias.