A pragmatic view of the usefulness of video-mediastinoscopy in the modern era

As a result of the introduction of new technologies, such as endoscopic (EUS) and endobronchial ultrasound (EBUS) guided aspiration, surgeons are moving away from routine mediastinoscopy prior to lung cancer resection. The scope of this article is two-fold: to describe in detail our technique of video-mediastinoscopy (VM), applied in more than 100 patients, and to clarify the current indications for its use. In the modern era, VM remains a fundamental technique in thoracic surgery as it is able to provide diagnosis for many thoracic conditions, overcoming some of the weaknesses associated with EBUS and EUS guided aspiration. VM is a valuable and irreplaceable tool in the mediastinal staging of patients affected by non-small cell lung cancer (NSCLC).