Mediastinoscopy

Why is this procedure done?

The area inside your chest between your lungs is the mediastinum. This area includes your heart, swallowing tube, and breathing tube. It also includes your thymus, blood vessels, and lymph nodes. Your doctor may use a special tool to check any of the body parts in this area. This is called a mediastinoscopy. The doctor may also take a small amount of tissue called a biopsy. This procedure is done to: ‚

Check tissues inside the mediastinum for any illnesses
Look for problems in the lungs, heart, and other parts of the body inside the mediastinum
Find certain types of infections, like tuberculosis
Look for lung cancer or lymphoma
Help the doctor know the stage of lung cancer
Help your doctor plan for more treatment like surgery, radiotherapy, or chemo

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What will the results be?

Your doctor will learn of any illnesses that are present. Together you can make a plan for your care. ‚

What happens before the procedure?

Your doctor will take your history. Talk to the doctor about: ‚

All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
Other health problems and earlier surgeries you have had. Be sure to tell your doctor if you had a mediastinoscopy or chest, neck, or open heart surgery. Tell the doctor if you have a history of a heart defect since birth or any problems with your neck or neck injury. Be sure your doctor knows about any radiation treatment to the neck or chest.
If you are not feeling well. An infection from a cold or sore throat may raise the risk of infection.
When you need to stop eating or drinking before your procedure.
Your doctor will do an exam and may order:
- Lab tests
- X-rays
- MRI scan
You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.

What happens during the procedure?

Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs.
When you are asleep, your doctor will put in a breathing tube through your mouth or a mask over your face to help you breathe. A small cut is made on your chest, just above your breast bone. The tube or scope is put in through the opening.
The doctor will guide this tool to the area in your chest. Then, a piece of tissue or lymph nodes will be taken and sent to the lab.
The doctor will take out the scope. Stitches or staples are used to close the opening and it is covered by a bandage. The tissue is sent to the lab for testing.
The procedure takes 30 minutes to 2 hours, based on how much tissue needs to be removed.

What happens after the procedure?

You will go to the Recovery Room for a few hours. The staff will watch you closely. Your doctor will give you drugs for pain.
The staff will take out your breathing tube or mask when you are awake and strong enough to breathe. You may have a sore throat afterwards. The staff will help you start to walk around. Doing coughing and deep breathing exercises will help keep your lungs clear.
Your doctor may take a chest x-ray to check for bleeding or other problems inside your chest.
You can go home after the surgery or you may need to stay in the hospital 1 to 2 days based on your condition.

What care is needed at home?

Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal activities like work, driving, or sex
Be sure to wash your hands before touching your wound or dressing.

What follow-up care is needed?

Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.

What lifestyle changes are needed?

Eat a healthy diet.
Be active. Exercise can help lower fatigue and low mood. If you feel tired, balance your activity with rest. Talk to your doctor about the right amount of activity for you.

What problems could happen?

Bleeding
Infection
Air leak from the lung
Injury to other tissue like your swallowing tube
Hoarseness of your voice
Chest pain
Collapsed lung

Where can I learn more?

American Cancer Society ‚
http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/Surgery/surgery-surgery-to-diagnose-and-stage-cancer ‚

Consumer Information Use and Disclaimer

This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚

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