Diagnostic and Therapeutic Applications of Video-Assisted Mediastinoscopy

Abstract

Since the 1950s, cervical mediastinoscopy has been a well-established technique for exploration of the anterior and superior mediastinum along with local lymph node biopsy. Despite current developments in mediastinal lymph node assessment such as fluorodeoxyglucose positron emission tomography integrated with computed tomography and endobronchial ultrasound with transbronchial-needle aspiration, mediastinoscopy remains the "gold standard" procedure for nodal staging of lung cancer. In recent years, the conventional mediastinoscope has been equipped with high definition optics offering a magnified and detailed image of the operating field with obvious advantages for the operator. Hence, the procedure has been renamed video-assisted mediastinoscopy. The new features enable a shared operative experience, facilitate teaching to junior surgeons, improve safety and accuracy of mediastinal exploration, and encourage exploration into further applications of the mediastinoscope.