Mediastinoscopy is a surgical procedure to examine the inside of
the upper chest between and in front of the lungs (mediastinum).
During a mediastinoscopy , a small cut (incision) is made in the neck just above
the breastbone or on the left side of the chest next to the breastbone. Then a
thin scope (mediastinoscope) is inserted through the opening. A tissue sample
(biopsy) can be collected through the mediastinoscope
and then examined under a microscope for lung problems, such as infection,
inflammation, or cancer.
In many cases
mediastinoscopy has been replaced by other biopsy methods that use
computed tomography (CT),
bronchoscopy to guide a biopsy needle to the abnormal
tissue. Mediastinoscopy may still be needed when these methods can't be used
or when they don't provide conclusive results.
Why It Is Done
Mediastinoscopy is done to:
- Detect problems of the lungs and mediastinum,
lung cancer or
Hodgkin's disease). Mediastinoscopy is often done to
check lymph nodes in the mediastinum before considering lung removal surgery to
treat lung cancer. Mediastinoscopy can also help your doctor recommend the best
chemotherapy) for lung cancer.
certain types of infection, especially those that can affect the lungs (such as
How To Prepare
You will be asked to sign a consent
form that says you understand the risks of the test and agree to have it done.
Talk to your doctor about any concerns you have
regarding the need for the test, its risks, how it will be done, or what the
results will mean. Be sure to discuss with your doctor what may be done
following each possible biopsy result. If a lymph node contains cancer, surgery
may be done to remove the cancer while you are still asleep. To help you
understand the importance of this procedure, fill out the
medical test information form(What is a PDF document?).
Before you have a mediastinoscopy,
tell your doctor if you:
- Are taking any medicines.
allergies to any medicines, including
- Have any bleeding problems or
take blood thinners, such as aspirin, clopidogrel (Plavix), or warfarin (Coumadin).
- Are or might be pregnant.
Also, certain conditions may make it more difficult to do a
mediastinoscopy. Let your doctor know if you have:
- Had a mediastinoscopy or open-heart surgery in
the past. The scarring from the first procedure may make it hard to do a
- A history of neck problems or a neck injury,
especially hyperextension of the neck.
- Any physical problems of
your chest, including those that have been present since birth
- Recently had radiation therapy to the neck or
You will receive
general anesthesia and be asleep during the
mediastinoscopy. To prepare for your procedure:
- Your doctor will tell you how soon before the
procedure to stop eating and drinking. Follow the instructions exactly about when to stop eating and drinking, or your surgery may be canceled. If your doctor has instructed you to take your medicines on the day of surgery, please do so using only a sip of water.
- Leave your jewelry at home. Any jewelry you wear will
need to be removed before the procedure.
- Remove glasses, contact
lenses, and dentures or a removable bridge just prior to the procedure. These
will be given back to you as soon as you wake up after the
- Arrange to have someone drive you home after the
procedure if you do not need to stay in the hospital.
Your doctor may order certain blood tests, such as a
complete blood count or clotting factors, before your procedure.