Medical Oncologist
CION Cancer Clinics
Rib resection: how many ribs can be removed | CION Cancer Clinics
There is no fixed limit on how many ribs can be removed. Surgeons regularly take several ribs in a row when a tumour needs it, and then rebuild the chest so it stays firm. What decides the number is the size of the tumour, the margin of healthy bone needed around it, and where on the chest it sits. This page explains what the team weighs, how a rib is taken out, and what to ask. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MM
Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
17+specialists on panel
15,000+patients treated
35+centres across Telangana & AP
4.8★ / 800+Google rating
On this page
- How many ribs can be removed in one operation?
- What actually decides how many ribs are taken
- How a rib is actually removed
- Words you will see, in plain language
- Four things families ask us, and what is actually true
- Who it does not suit, and what this page cannot tell you
- Common questions about rib resection
The short answer
How many ribs can be removed in one operation?
There is no fixed limit. Surgeons regularly remove several ribs in a row when a tumour needs it, and the chest is then rebuilt so that it stays firm. What decides the number is the size of the tumour and the margin of healthy tissue needed around it, not a rule about ribs.
Why the number itself matters less than where
The chest wall does two jobs. It protects the heart and lungs, and it moves with every breath. Removing one or two ribs at the back, under the shoulder blade, changes very little because the shoulder blade covers the gap. Removing the same number at the front or side leaves a soft patch that can move the wrong way when you breathe, so it is usually bridged with mesh or a plate.
What your team is weighing
Your surgeon looks at how many ribs the tumour touches, whether the breastbone or the lung is involved, and how well your lungs work now. Someone with strong breathing reserve can lose part of the chest wall and barely notice after a few months. Someone with long-standing lung disease may not.
If a surgeon has told you a number, it is a plan based on your scans. The final count is confirmed in theatre, once the tumour can be seen and felt.The deciding factors
What actually decides how many ribs are taken
Four things, weighed together at the tumour board.
The tumour and its margin
The tumour is removed with a rim of healthy tissue all the way round. For a rib tumour that usually means taking the rib above and the rib below as well, so that the margin is made of bone rather than of the soft tissue between the ribs.
Where on the chest it sits
Ribs at the back are covered by the shoulder blade and thick muscle. Ribs at the front and side are not. The same gap needs a firmer reconstruction at the front than at the back.
Whether the lung or breastbone is involved
If the tumour is stuck to the lung, a wedge of lung comes out with the ribs. If it reaches the breastbone, part of that is taken too and the reconstruction becomes larger. Both are planned before the day.
Your breathing reserve
Lung function tests before surgery show how much reserve you have. Smokers, and people with asthma or other lung disease, may be asked to do breathing exercises for a few weeks first, and the team may plan a firmer reconstruction to protect their breathing.
Tests you may be asked for
- Spirometry (blowing into a tube)
- A walk test
- An echo of the heart
Not sure whether this applies to you?
Ask an oncologistIn the theatre
How a rib is actually removed
Reaching the rib
Under general anaesthetic, the skin and muscle over the rib are opened. If the tumour involves the muscle, that part stays attached to the rib and comes out with it.
Freeing the rib
The thin sleeve around the bone is lifted where the rib is healthy. Where the tumour is, the surgeon stays well clear and takes the sleeve, the muscles between the ribs and the lining beneath as one block.
Cutting above and below the tumour
The rib is cut with a margin of healthy bone at each end. The small artery, vein and nerve that run along the underside of each rib are tied off, which is why the skin over the area is numb afterwards.
Rebuilding the gap
A small gap at the back may simply be closed with muscle. A larger or front-of-chest gap is bridged with mesh, a plate or a flap. A drain is placed and the wound is closed in layers.
On your operation note
Words you will see, in plain language
- Rib segment
- A length of rib, rather than the whole rib from spine to breastbone. Most rib resections remove segments.
- Intercostal
- Between the ribs. The intercostal muscles, vessels and nerve run in the space under each rib.
- Periosteum
- The thin living sleeve around a bone. It is taken with the rib wherever the tumour is close.
- Costal cartilage
- The soft cartilage joining the front of a rib to the breastbone. Often removed with the rib for tumours at the front.
- Rigid reconstruction
- Bridging the gap with something firm, such as a plate or a stiffened mesh, so that the chest does not move inwards on breathing in.
- Non-rigid reconstruction
- Bridging the gap with soft mesh or muscle only. Used for smaller gaps and for gaps under the shoulder blade.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Commonly believed
Four things families ask us, and what is actually true
"You cannot live without your ribs."
People live full lives after losing several ribs. The ribs are a cage, not an organ. What the body needs is a chest wall that stays firm enough to breathe against, and that is what the reconstruction provides.
"Fewer ribs removed means a safer operation."
Not if it leaves tumour behind. Taking the rib above and below gives a margin of bone, which the pathologist can check. A tighter operation that leaves cancer at the edge usually means a second operation or radiotherapy.
"The heart will be unprotected afterwards."
Where the gap sits over the heart, the surgeon uses a firm reconstruction for that reason. The plate or stiffened mesh takes the place of the bone, and scar tissue thickens around it over the following months.
"He will never lift anything again."
Heavy lifting is restricted while the repair settles. After that, most people return to farm work, driving and carrying children. The arm on that side may feel weaker for a while, and physiotherapy helps.
!
After discharge, one thing that cannot wait
A patch of the chest that sinks inwards when you breathe in and bulges when you breathe out, sudden breathlessness, a fever with shivering, or a wound that is red, hot or leaking. Go the same day to the hospital where you had the operation or the nearest emergency department, and say you have had ribs removed. Do not wait for the next clinic date.
Being straight with you
Who it does not suit, and what this page cannot tell you
This page cannot tell you how many ribs your operation will involve. That number comes from your CT, your MRI and the surgeon's hands on the day. It also cannot tell you how your breathing will feel afterwards, because that depends on your lungs before the operation as much as on what is removed.
When the team may hold back
If your lung function is already poor, a large rib resection may leave you more breathless than the tumour does, and the team may suggest radiotherapy or medicines instead. If the tumour has spread elsewhere, removing ribs rarely changes the course of the illness. If the tumour wraps around the spine or the large vessels near the heart, a full margin may not be possible. These are decisions for you and your treating team.
Questions worth asking your surgeon
How many ribs do you expect to remove, and at the front or the back? Will the gap need a plate or mesh? Will part of the lung come out too? What will my breathing be like in the first weeks, and who do I call if it changes? Write the answers down.
Bring the family member who will help care for you at home. They will be the one watching the wound and the breathing.Questions we are asked
Common questions about rib resection
Is there a maximum number of ribs a surgeon will remove?
No fixed maximum. The number is set by the tumour and its margin. Removing several ribs in a row is done regularly when the gap can be rebuilt firmly and the lungs are strong enough. What limits the operation is your breathing reserve and whether a clear margin is possible, not a count.
Why is the surgeon removing ribs that look normal on the scan?
To give a margin of bone above and below the tumour. Cancer cells can spread along the rib and the space beneath it further than a scan shows. Taking the neighbouring ribs means the pathologist can confirm the edges are clear.
Will the ribs grow back?
No. Removed bone does not regrow. Sometimes, if the outer sleeve of the rib is left in place, a thin strip of new bone forms along it over time, but that cannot be relied on. The gap is bridged during the operation and stays bridged.
Will I be able to breathe normally afterwards?
In the first weeks breathing feels shallow, mostly because of pain and the drain. That improves as the wound settles. Most people are back to their usual activity within a few months. If your lungs were weak before surgery, the change may be more noticeable, and your team will have discussed this.
Why is the skin numb below the scar?
The nerve to that patch of skin runs under each rib and is cut with it. Numbness or an odd tingling below the scar is expected and is not a sign that something went wrong. It often improves over many months but may not fully return.
Can this be done with keyhole surgery?
Removing a rib with a tumour needs a cut wide enough to take the block out in one piece, so it is an open operation. A camera is sometimes used alongside it to check the lung. Ask your centre what approach they plan and why.
How long will I be in hospital?
Usually about a week, sometimes longer if a large reconstruction was done or if breathing needs support early on. The drain comes out when the fluid slows. You go home when you are walking, eating and managing pain with tablets.
Will I be able to feel the plate or mesh?
Sometimes, especially in a slim person, as a firm edge under the skin. It should not hurt once the wound has settled. A plate that becomes painful, moves or breaks the skin needs to be seen, because it may have loosened or become infected.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
Sources
- Cancer Research UK — Surgery for cancer
- NHS — Bone cancer
- National Cancer Institute — Surgery to Treat Cancer
- Macmillan Cancer Support — Surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Chest Wall Resection: What Is RemovedEvery layer the operation can involveChest Wall Reconstruction: Mesh and FlapsHow the gap left by the ribs is bridgedFlail Chest and Paradoxical MovementWhat happens if a gap is not firm enoughFitness, Tests and PrehabilitationThe breathing tests done before surgeryPain After Cancer SurgeryWhat to expect and how it is managed
Talk to us
Been told ribs may need to be removed?
Send us the CT or MRI report or call the helpline. A surgical oncologist will explain what is being proposed and what to ask about the reconstruction. One helpline serves every CION centre.