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Mediastinoscopy
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. See a picture of
mediastinoscopy
.
In many cases mediastinoscopy has been replaced by other biopsy methods that use computed tomography (CT), echocardiography, or bronchoscopy to guide a biopsy needle to the abnormal tissue. Mediastinoscopy may still be needed when these methods cannot be used or when they do not provide conclusive results.
Why It Is Done
Mediastinoscopy is done to:
- Detect problems of the lungs and mediastinum, such as sarcoidosis.
- Diagnose lung cancer or lymphoma (including 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 treatment (surgery, radiation, chemotherapy) for lung cancer.
- Diagnose certain types of infection, especially those that can affect the lungs (such as tuberculosis).
How To Prepare
You will be asked to sign a consent
form before mediastinoscopy. 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.
- Have allergies to any medicines, including anesthetics.
- Have any bleeding problems or take blood thinners, such as aspirin 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 difficult to do a second procedure.
- 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 (congenital).
- Recently had radiation therapy to the neck or chest.
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. In most cases, you will need to stop eating at least 6 hours before your procedure. You may be able to drink clear liquids, such as water, coffee, or tea, up to 2 hours before the procedure. But be sure to follow the exact instructions your doctor gives you. If you take daily medicines, ask your doctor whether you should take them on the day of the procedure.
- 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 procedure.
- 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 bleeding factors, before your procedure.
WebMD Medical Reference from Healthwise
An emerging field of medicine called interventional pulmonology is providing never-before-seen views during delicate surgeries.
