Extended cervical mediastinoscopy.

The technique of extended cervical mediastinoscopy is described in detail as well as its indications for use. The author has found extended cervical mediastinoscopy extremely valuable in staging lung carcinoma with regard to level V and VI lymph node involvement if a standard cervical mediastinoscopy fails to demonstrate metastatic disease and a CT scan suggests subaortic lymph node involvement. This technique has been found to be safe and accurate and only adds minimal operating time to a cervical mediastinoscopy without the need for a second incision.