The mediastinum is the area in the middle of the chest between the lungs. A mediastinoscopy is a procedure to look at this area inside the chest. A tube with a light (mediastinoscope) is placed into the upper chest through a small opening (mediastinotomy). The light allows the doctor to see the area.
The Lungs (Cut-away View)
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This is done to examine the lungs and chest. Tissue samples may be taken (
). These samples are viewed under a microscope to check for diseases like:
Cancer of the
, bronchi, and chest tissue
Lymphoma—cancer in the lymphatic system, such as Hodgkin’s diseaseInfectionInflammationSarcoidosis
—a condition that causes swelling (inflammation) in organs like the lungs, liver, lymph nodes, and spleen
Mediastinoscopy is also done to find out if lung cancer has spread.
Complications are rare, but no procedure is completely free of risk. If you are planning to have mediastinoscopy, your doctor will review a list of possible complications, which may include: BleedingInfectionHoarsenessChylothorax—leakage of lymphatic fluid into the chestDamage to organs in the chestPneumothorax
Factors that may increase the risk of complications include: Previous mediastinoscopy or chest or neck surgeryPregnancyDiabetes or other chronic diseaseSmoking
Discuss these risks with your doctor before this procedure.
Your doctor will explain the procedure to you and ask you to sign a consent form. You will be asked to stop eating and drinking for 8-10 hours before the procedure. Your doctor will tell you whether you should: Take any medications before the procedureStop taking certain medications before the procedure
The day of the procedure: You will be asked to remove any jewelry, glasses, contact lenses, or dentures.Be sure to tell your doctor if you have any allergies.You will need someone to drive you home after the procedure.
You will receive a
through an IV in your hand or arm. This will block any pain and keep you asleep throughout the procedure. When you are sedated, a breathing tube will be placed in your throat to help you breathe.
You will lie on the operating table on your back. Your skin will be cleaned with an antiseptic solution. A small cut will be made at the base of your neck, just above your breastbone. The muscles of your lower back will be separated. The mediastinoscope will be placed through the opening. The light from the mediastinoscope will help the doctor see the space between your lungs and heart. Tissue samples may be taken from the lymph nodes or other parts of your chest. The mediastinoscope will be removed and the opening will be closed with stitches. The wound will be covered with a dressing.
After the procedure, you will be taken to the recovery room. If all is well, your breathing tube will likely be removed. The tissue samples will be sent to the laboratory for testing.
General anesthesia prevents pain during surgery. You may be given medication to manage pain and tenderness after the procedure.
This procedure can be done in an outpatient setting or as part of your hospital stay. The usual length of stay is up to 24 hours if there are no unforeseen complications. Some people may need to stay in the hospital for 1-2 days.
You will be taken to the recovery room after the procedure until the anesthetic wears off.
Achest x-ray may be ordered
to check for bleeding or air inside your chest space.
Be sure to follow your doctor’s instructions.
After you leave the hospital, contact your doctor if any of the following occurs: Redness, swelling, pain, or bleeding from the woundChest painSwelling in the neckDifficulty swallowingHoarseness that lasts for more than a few days or worsensShortness of breathSigns of infection, including fever and chillsJoint pain, fatigue, stiffness, rash, or other new symptoms
In case of an emergency, call for emergency medical services right away.
Mediastinoscopy. Harvard Health Publications website. Available at:
http://www.health.harvard.edu/diagnostic-tests/mediastinoscopy.htm. Updated June 26, 2014. Accessed February 24, 2015.
6/6/2011 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis.
Am J Med.
Last reviewed February 2015 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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