The best replacement for mediastinoscopy is ebus.

The best alternatives to mediastinoscopy are rated as following:
★★★★★  ebus
★★★  thoracoscopy
★★★  mediastinotomy
★★  bronchoscopy

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Google Trends

Scale is based on the average worldwide traffic of mediastinoscopy in all years. Click on graph for more.
mediastinoscopy
ebus
thoracoscopy