For years cervical mediastinoscopy was the main and only way to access the mediastinal status on lung cancer, but on the last decade new technologies had evolved either imaging, endoscopic or surgical procedures. Each one can give you very good results, but still have a different degree of certainty detecting anatomical extent of disease. Based on some published data and on our experience, we will address the use of video-assisted mediastinal lymphadenectomy (VAMLA) and trans-cervical extended maximal lymphadenectomy (TEMLA), named by Dr. Rami Porta as supermediastinoscopies, show procedures differences and where do we fit them on our practice.