Anterior mediastinotomy via 2-4 cm incision over the 2nd-3rd interspace to reach lymph nodes that cannot be reached via EBUS or mediastinoscopy is known as which procedure?

• A. Chamberlain procedure
• B. Mediastinoscopy
• C. Pleural biopsy
• D. VATS

Answer: (A)

Anterior mediastinotomy, or the Chamberlain procedure, is a targeted surgical approach to access anterior mediastinal lymph nodes that cannot be reached with EBUS or mediastinoscopy. It uses a small left parasternal incision in the second intercostal space to directly reach nodes in the anterior superior mediastinum and the aortopulmonary window, allowing biopsy for accurate staging when less invasive routes fail. Mediastinoscopy samples upper and paratracheal nodes via a neck route, pleural biopsy targets the pleura, and VATS is a thoracoscopic approach to the pleural space and lungs; none of these provide the same direct access to those anterior mediastinal nodes as the Chamberlain procedure.