Abstract: The mediastinoscope introduced by Carlens in 1959 had a significant improvement when in 1992 Linder and Dahan developed a two bladed video-mediastinoscope that allowed the possibility of bimanual preparation. This increases the possibility of performing a mediastinal lymphadenectomy instead of lymph nodes biopsies. In 1999, Hürtgen et al. developed the video-assisted mediastinal lymphadenectomy (VAMLA) technique to improve the sensitivity of mediastinoscopy. Currently, health-care differences between high-income countries (HIC) and low- and middle-income countries (LMIC) are clear. The presence of obstacles to access health systems generates delays in care and worse results. Furthermore, the absence of technologies that are routinely used in HIC marks a huge gap between these countries and LMIC. The video-mediastinoscope is one of them. In Colombia, it is only available in four major cities, and although it is well known that mediastinal lymphadenectomy occupies a place very important in the management of patients with lung cancer, VAMLA is not a very popular procedure. The advantage of VAMLA is the most adequate preoperative diagnosis of factor N, as well as a complete lymphadenectomy for the surgical treatment of non-small cell lung cancer (NSCLC). The objective of this review is to present the technique and show how we do it in a developing country where we do not always have a video-mediastinoscope.