A small, four-bladed Finochietto retractor is a self-retaining chest retractor designed to spread the ribs and provide optimal visibility during thoracic surgery in smaller patients, such as infants, children, and small animals. The small size is vital for safely accessing the chest cavity in smaller anatomies. 

The small Finochietto retractor is a standard tool in pediatric cardiothoracic surgery for procedures including:

Esophageal surgery:

To repair a tracheoesophageal fistula, a congenital condition where the esophagus is not properly connected to the stomach and has an opening to the trachea.

Cardiac surgery:

For accessing the heart in infants and children to repair congenital heart defects.

Lung resections:

To remove diseased portions of the lung.