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ICD-9-CM 34.22
MeSH D008481
OPS-301 code 1-691.1

Mediastinoscopy is a procedure that enables visualization of the contents of the mediastinum, usually for the purpose of obtaining a biopsy.[1] Mediastinoscopy is often used for staging of lymph nodes of lung cancer or for diagnosing other conditions affecting structures in the mediastinum such as sarcoidosis or lymphoma.[citation needed]

Mediastinoscopy involves making an incision approximately 1 cm above the suprasternal notch of the sternum, or breast bone. Dissection is carried out down to the pretracheal space and down to the carina. A scope (mediastinoscope) is then advanced into the created tunnel which provides a view of the mediastinum. The scope may provide direct visualization or may be attached to a video monitor.[citation needed]

Mediastinoscopy provides access to mediastinal lymph node levels 2, 4, and 7.[citation needed]

Current Use[edit]

Historically, mediastinoscopy has been the gold standard for the staging of lung cancer. However, with advances in minimally invasive procedures and imaging, mediastinoscopy usage has declined significantly.[2]

Extended mediastinoscopy[edit]

Extended mediastinoscopy is a technique which allows access to the pre-aortic (station 6) and aortopulmonary window (station 5) lymph nodes.[citation needed]

Parasternal mediastinotomy[edit]

Parasternal mediastinotomy, aka, a Chamberlain procedure, is the standard approach to access lymph nodes at stations 5 and 6.[citation needed]


  1. ^ Kaiser LR (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. pp. 1853–1854. ISBN 0-07-145739-9. 
  2. ^ Vyas, Krishna S.; Davenport, Daniel L.; Ferraris, Victor A.; Saha, Sibu P. (2013). "Mediastinoscopy". Southern Medical Journal 106 (10): 539–44. doi:10.1097/SMJ.0000000000000000. PMC 4387790. PMID 24096946.