The mediastinum is the area in the middle of the chest between the lungs. A mediastinotomy is the creation of a small opening in the upper chest into the mediastinum. This opening allows the doctor to examine the area between and in front of the lungs.
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This procedure is done to examine the lungs and chest. Your doctor might take tissue samples (biopsy). These samples are examined under a microscope to check for diseases like:
Mediastinotomy is also done to find out if lung cancer has spread.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
You will be asked to stop eating and drinking for 8-10 hours before the procedure.
You may be asked to stop taking some medications up to one week before the procedure.
On the day of the procedure:
General anesthesia—you will be asleep during the procedure
The doctor will make a small cut in the chest. Muscles will be moved aside in order to examine the space between the lungs and heart. Samples may be taken from the lungs, lymph nodes, or other chest tissue. The doctor will close the incision with stitches. The wound will be covered with a dressing or bandage.
You will be taken to the recovery room for monitoring.
30 minutes to 2 hours
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
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.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
There are also steps you can take to reduce your chance of infection, such as:
You will have restrictions on specific activities during your recovery. Follow instructions on wound care to prevent infection. Your doctor may advise pain medications to ease discomfort.
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
If you think you have an emergency, call for medical help right away.
Chamberlain procedure. Roswell Park Cancer Institute website. Available at: https://www.roswellpark.org/glossary/chamberlain-procedure Accessed February 2, 2015.
Mediastinoscopy and mediastinotomy. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/pulmonary_disorders/diagnostic_pulmonary_procedures/mediastinoscopy_and_mediastinotomy.html. Updated September 2013. Accessed February 2, 2015.
Sarcoidosis in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 1, 2014. Accessed February 2, 2015.
6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed January 2015 by Michael Woods, MDLast Updated: 1/23/2014