Because the anatomy of the costovertebral angle is complex and often unfamiliar to the operating thoracic surgeon, surgical procedures performed in that area must be done by a surgical team rather than by individual surgeons, and such a team usually includes either an orthopedic surgeon or a neurosurgeon. This is the case, for example, of Pancoast’s tumors invading the roots of the brachial plexus or the spine itself where the help of an orthopedic surgeon is invaluable not only to achieve a complete resection but also to prevent catastrophic complications.