The mediastinum is the area in the middle of the chest between the lungs. A mediastinoscopy is a procedure to look at this area inside the chest. A tube with a light (mediastinoscope) is placed into the upper chest through a small opening (mediastinotomy). The light allows the doctor to see the area.
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This is done to examine the lungs and chest. Tissue samples may be taken ( biopsy). These samples are viewed under a microscope to check for diseases like:
Mediastinoscopy is also done to find out if lung cancer has spread.
Complications are rare, but no procedure is completely free of risk. If you are planning to have mediastinoscopy, your doctor will review a list of possible complications, which may include:
Factors that may increase the risk of complications include:
Discuss these risks with your doctor before this procedure.
Your doctor will explain the procedure to you and ask you to sign a consent form. You will be asked to stop eating and drinking for 8-10 hours before the procedure. Your doctor will tell you whether you should:
The day of the procedure:
You will receive a general anesthetic through an IV in your hand or arm. This will block any pain and keep you asleep throughout the procedure. When you are sedated, a breathing tube will be placed in your throat to help you breathe.
You will lie on the operating table on your back. Your skin will be cleaned with an antiseptic solution. A small cut will be made at the base of your neck, just above your breastbone. The muscles of your lower back will be separated. The mediastinoscope will be placed through the opening. The light from the mediastinoscope will help the doctor see the space between your lungs and heart. Tissue samples may be taken from the lymph nodes or other parts of your chest. The mediastinoscope will be removed and the opening will be closed with stitches. The wound will be covered with a dressing.
After the procedure, you will be taken to the recovery room. If all is well, your breathing tube will likely be removed. The tissue samples will be sent to the laboratory for testing.
30 minutes to 2 hours
General anesthesia prevents pain during surgery. You may be given medication to manage pain and tenderness after the procedure.
This procedure can be done in an outpatient setting or as part of your hospital stay. The usual length of stay is up to 24 hours if there are no unforeseen complications. Some people may need to stay in the hospital for 1-2 days.
Be sure to follow your doctor’s instructions.
After you leave the hospital, contact your doctor if any of the following occurs:
In case of an emergency, call for emergency medical services right away.
American Cancer Society
American Lung Association
Mediastinoscopy. Harvard Health Publications website. Available at: http://www.health.harvard.edu/diagnostic-tests/mediastinoscopy.htm. Updated June 26, 2014. Accessed February 24, 2015.
6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed February 2015 by Marcin Chwistek, MDLast Updated: 6/20/2013