The usual practice was to peel the skin, fat, and muscles—the soft tissues—away from the rib cage on both sides along the previously made incision line, revealing the thoracic cavity.
After peeling away the soft tissue layers and turning them outward, the surface of the rib cage was completely exposed. Next, preparations to open the thoracic cavity commenced, which meant breaking open the ribs.
This was a technical task, requiring an anatomical scalpel to sever each costal cartilage and intercostal muscle, followed by cutting through the sternoclavicular joint and the first rib.
Sometimes, when a scalpel wouldn't suffice, other tools had to be used—axes, pliers, saws—anything to break the first rib.
Once the ribs were completely severed, the rib arch was lifted close to the posterior wall of the sternum and costal cartilage to separate the transverse sternal part and the mediastinal connective tissue. At this point, removing the sternum exposed the thoracic cavity.
