Lung Disease & Respiratory Health Center

How It Is Done

Mediastinoscopy is done by a chest (thoracic) surgeon and surgical assistants.

Before the procedure, an intravenous (IV) line will be placed in a vein to give you fluids and medicines. After you are asleep, a tube will be placed in your throat (endotracheal or ET tube) to help you breathe during the procedure. Your neck and chest will be washed with an antiseptic soap and covered with a sterile drape.

An incision will be made just above your breastbone at the base of your neck or on the left side of your chest near the breastbone between the 4th and 5th ribs. The mediastinoscope will be inserted through the opening. Your doctor will examine the space in your chest between your lungs and heart. Lymph nodes or abnormal tissue will be collected for examination. After the scope is removed from your chest, the incision will be closed with a few stitches and covered with a bandage.

The entire procedure usually takes about an hour. After the procedure, you will be taken to the recovery room.

Some people may go home after the procedure if the general anesthesia wears off and they are able to swallow fluids without gagging or choking. Other people may need to stay in the hospital for 1 or 2 days. If your stitches are not the dissolving type, you will need to return to your doctor in 10 to 14 days to have them removed. Mediastinoscopy usually leaves only a tiny scar.

How It Feels

Before the procedure, you may be given medicine that will make you sleepy and relaxed. You will receive general anesthesia during the mediastinoscopy, which will cause you to be asleep. After you wake up, you may feel sleepy for several hours. You may feel tired for 1 to 2 days after the procedure and have some general aches and pains. You may also have a mild sore throat from the tube in your throat during the procedure. Using throat lozenges and gargling with warm salt water may help relieve your sore throat.

Risks

Complications from mediastinoscopy are uncommon but may include bleeding, infection, a collapsed lung (pneumothorax), a tear in the esophagus, damage to a blood vessel, or injury to a nerve near the voice box (larynx) which may cause permanent hoarseness.

After the procedure, contact your doctor immediately if you have:

• Bleeding from your stitches.
• A fever.
• Severe chest pain.
• Swelling in the neck.
• Shortness of breath.
• Difficulty swallowing.
• Hoarseness of your voice that lasts more than a few days or continues to get worse.

Results

Mediastinoscopy is a surgical procedure to examine the inside of the chest between and in front of the lungs (mediastinum).