Between 1990 and 2001 in Thoracic Surgery Department at SHATPD "Saint Sophia"--Sofia a total of 821 patients with pulmonary hydatidosis were operated on. In 5 (0.6%) of them the cysts were situated in the both lungs, lever and spleen. For the first time in the surgical practice a sterno-laparotomy were carried out for one-stage cysts' removal in this multi-organ localization. The stages of this approach as well as the indications and contraindications for its applications are described in detail.