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Updated: May 4, 2026

Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
Published on: February 27, 2026
Transcervical extended mediastinal lymphadenectomy
Marcin Zielinski1, Jaroslaw Kuzdzal, Tomasz Nabialek
1Department of Thoracic Surgery, Pulmonary Hospital in Zakopane, ul. Gładkie 1, 34-500 Zakopane, Poland.
Abstract:
Transcervical extended mediastinal lymphadenectomy (TEMLA) is a new procedure for bilateral excision of all nodal stations of the mediastinum, except for the pulmonary ligament nodes (station 9) and the most distal left lower paratracheal nodes (station 4L). The procedure is performed through a transverse 5-8 cm incision in the neck with elevation of the sternum with a traction device facilitating the access to the mediastinum. Most of the procedure is performed with an open technique, while the removal of the subcarinal (station 7) and periesophageal nodes (station 8) is performed with the mediastinoscopy assisted technique and excision of the paraaortic nodes (station 6), the aorta-pulmonary window nodes (station 5) and, sometimes, the prevascular nodes (station 3A) is performed with the aid of a videothoracoscope introduced to the mediastinum through the neck incision, without violating the pleura.

