Introduced in the 1990s, videomediastinoscopes dramatically improved imaging of the mediastinal structures, and made mediastinoscopy more standardized, user-friendly, and accessible to trainees. Not surprisingly they have been replacing conventional mediastinoscopes for routine biopsy and staging procedures. However it was development of the two-bladed spreadable videomediastinoscope by Linder and Dahan that allowed increased exposure, bimanual dissection, and thus the development of new minimally invasive surgical techniques. The best documented method is video-assisted mediastinoscopic lymphadenectomy (VAMLA), which enables extremely accurate staging and definitive mediastinal surgery.