Mediastinoscopy is a thoracic surgical procedure performed with a mediastinoscope to examine the mediastinum—the space in the thoracic cavity between the lungs—for various indications, including diagnostic tissue sampling, mediastinal lymph node biopsy, and staging of tissue, nodes, and metastasis. Mediastinoscopy has a high sensitivity (>80%) and specificity (100%) in the staging of lung cancer.
Mediastinoscopy can be classified into 2 different procedures:
Cervical mediastinoscopy: Provides access to the pretracheal, paratracheal, and anterior subcarinal lymph nodes
Transthoracic mediastinoscopy: Also known as Chamberlain procedure or anterior mediastinotomy; a more involved procedure that allows for dissection of the aortopulmonary lymph nodes
Surgery in the mediastinum was first described in 1899 when a superior mediastinal abscess was successfully drained. The procedure was advanced in Europe in the early 20th century. Still, it was rarely performed outside Europe until the late 1950s when Eric Carlens of Sweden introduced the mediastinoscope as a surgical instrument. This new rigid instrument allowed a surgeon to enter the mediastinum through a suprasternal incision and biopsy paratracheal and hilar lymph nodes.
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