Endoscopy of the Chest (Mediastinoscopy)

What is mediastinoscopy?

Mediastinoscopy is a procedure in which your healthcare provider takes a sample of tissue, often lymph node tissue, from the area between your lungs and above your heart. The tissue is then tested in the lab.

When is it used?

A mediastinoscopy is done when there is a problem in the tissue between your lungs and above your heart. The tissue may have grown too big, it may have gotten too thick, or it may be cancerous. Lymph nodes can be checked for certain diseases or tumor spread.

Examples of alternatives include:

• having a CT (computerized tomography) scan
• choosing not to have treatment, recognizing the risks of your condition.

You should ask your healthcare provider about these choices.

How do I prepare for a mediastinoscopy?

Plan for your care and recovery after the procedure. Arrange for someone to drive you home after the procedure. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow your provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your wounds will heal much better if you do not smoke after the surgery.

Follow any instructions your provider may give you. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

A general anesthetic is given. It will relax your muscles and put you to sleep. It will prevent you from feeling pain during the operation.

Your healthcare provider makes a small cut (incision) in the lower part of your neck just above the sternum (the bone down the middle of the chest) and puts a tube into your chest. Your provider can look through this tube to see inside your chest. Your provider locates the lymph nodes and removes a piece of them.

What happens after the procedure?

You may stay in the hospital for a day. Your healthcare provider will tell you if further treatment is necessary.

Ask your provider what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

It will help your healthcare provider make a more accurate diagnosis.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your healthcare provider.
• The veins or arteries in the area could be damaged. Such damage can be serious because these blood vessels are quite large. If this happens you may need surgery to open the chest through the sternum (breastbone) to control the bleeding.
• Your lung(s) could collapse and need reinflating.
• You may have infection or bleeding.

You should ask your provider how these risks apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• You develop a fever over 100°F (37.8°C).
• You develop redness, swelling, pain, or drainage from your incision.
• You become short of breath.
• You develop uncontrollable chest pain.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.