The mediastinum is the area in the middle of the chest between the lungs. A mediastinotomy is the creation of a small opening in the upper chest into the mediastinum. This opening allows the doctor to examine the area between and in front of the lungs.
The Lungs (Cut-away View)
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This procedure is done to examine the lungs and chest. Your doctor might take tissue samples (biopsy). These samples are examined under a microscope to check for diseases like:
Cancer of the
lungs, bronchi, and chest tissue
Lymphoma—cancer in the lymphatic system, such as
Hodgkin’s diseaseInfectionInflammationSarcoidosis—a condition that causes inflammation in organs like the lungs, liver, lymph nodes, and spleen
Mediastinotomy is also done to find out if lung cancer has spread.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: BleedingInfectionHoarsenessChylothorax—leakage of lymphatic fluid into the chestDamage to organs in the chestAir getting trapped between the lungs and chest wall—pneumothorax
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as: SmokingDrinking
Chronic diseases, such as
You will be asked to stop eating and drinking for 8-10 hours before the procedure.
You may be asked to stop taking some medications up to one week before the procedure.
On the day of the procedure: You will be asked to remove any jewelry, glasses, contact lenses, or dentures.You may be given medications to help you feel sleepy and relaxed.Be sure to tell your doctor if you have any allergies.You will need someone to drive you home after the procedure.
The doctor will make a small cut in the chest. Muscles will be moved aside in order to examine the space between the lungs and heart. Samples may be taken from the lungs, lymph nodes, or other chest tissue. The doctor will close the incision with stitches. The wound will be covered with a dressing or bandage.
You will be taken to the recovery room for monitoring.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
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.
In the recovery room, the care staff will monitor your breathing, pulse, and heart rate.
Your doctor may order a
to check for bleeding or air inside your chest space.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as: Washing your hands often and reminding your healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incision
You will have restrictions on specific activities during your recovery. Follow instructions on wound care to prevent infection. Your doctor may advise pain medications to ease discomfort.
Contact your doctor if your recovery is not progressing as expected or you develop complications, such as: Redness, swelling, pain, or bleeding from the woundChest painSwelling in the neckDifficulty swallowingHoarseness that lasts more than a few days or worsensShortness of breathSigns of infection, including fever and chillsJoint pain, fatigue, stiffness, rash, or other new symptoms
If you think you have an emergency, call for medical help right away.
Chamberlain procedure. Roswell Park Cancer Institute website. Available at:
https://www.roswellpark.org/glossary/chamberlain-procedure Accessed February 2, 2015.
Mediastinoscopy and mediastinotomy. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/pulmonary-disorders/diagnostic-pulmonary-procedures/mediastinoscopy-and-mediastinotomy. Updated September 2013. Accessed February 2, 2015.
Sarcoidosis in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 1, 2014. Accessed February 2, 2015.
6/6/2011 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis.
Am J Med.
Last reviewed March 2016 by Donald Buck, 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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