Mediastinoscopy

Mediastinoscopy is a minimally invasive procedure used to examine and obtain tissue samples from the mediastinum, the area in the chest between the lungs. This procedure is often performed to investigate conditions like lung cancer, lymphoma or infections that affect the lymph nodes or other structures in the chest. The procedure has a relatively quick recovery time, and it is a valuable tool for diagnosing conditions in the chest.

Before the procedure, the patient will undergo some tests, such as blood work or imaging scans (like a CT scan), to assess their overall health and confirm that mediastinoscopy is necessary.

The patient may be asked to stop eating or drinking for several hours before the procedure, especially if it is done under general anesthesia.

Mediastinoscopy is usually done under general anesthesia, which means the patient will be asleep and pain-free during the procedure.

Sometimes, local anesthesia is used if the procedure is less invasive, but general anesthesia is more common for thorough examination and biopsies.

The surgeon makes a small incision at the base of the neck, just above the breastbone. This is where a special instrument called a mediastinoscope is inserted.

The mediastinoscope is a rigid metal tube with a light and camera attached, allowing the surgeon to see inside the mediastinum (tissue inside the chest between the lungs). It may be attached to a video monitor so the surgeon can closely examine the lymph nodes, blood vessels, and other structures in this area.

If necessary, tissue samples (biopsies) are taken from the lymph nodes or other areas for further examination.

After the procedure, patients are typically monitored in a recovery room as the anesthesia wears off. The procedure is usually done on an outpatient basis, so most patients can go home the same day, although some may need to stay overnight if they have had a more complicated procedure or if they need additional monitoring.

Pain or discomfort at the incision site is common, and the doctor may prescribe pain medication to manage this. Typically, patient pain can be managed with acetaminophen or ibuprofen.

The patient may be advised to avoid strenuous activities or heavy lifting for a period of time after the procedure.

As with any surgical procedure, there are risks associated with mediastinoscopy, such as bleeding, infection or damage to nearby structures (like blood vessels or the windpipe). Damage to the recurrent laryngeal nerve can be caused by a mediastinscopy. However, serious complications are rare.

The doctor will explain these risks in detail before the procedure and will take steps to minimize them.

Once the biopsy results are available, the doctor will discuss them with the patient to determine the next steps, whether it’s further treatment, monitoring, or other diagnostic procedures.