Mediastinoscopy
A form of surgery that is often used as a diagnostic test, mediastinoscopy allows doctors to view the middle of the chest cavity and to do small surgical procedures in that area, such as the removal of lymph nodes to test for cancer. Mediastinoscopy also allows doctors to examine and evaluate tumors or masses in the middle of the chest.
The procedure is done in an operating room under general anesthetic, which means that the patient is not awake during the mediastinoscopy. A surgeon or pulmonary specialist makes a small incision above the breastbone and fills the area with carbon dioxide gas, allowing the lung to collapse slightly so that the doctor has more room to work. Through that same one-inch incision, the surgeon can insert a mediastinoscope - a small camera - which allows him to see what he is doing via a nearby video screen.
Other small incisions may be made to allow the doctor to insert other surgical instruments, such as those which can remove lymph nodes for examination. Normally, these incisions are made between the ribs. At the end of the procedure, all instruments are removed and the lung is re-inflated.
Risks following the procedure are low. Discomfort may be felt at the site of the incisions and, in rare cases, procedures in the middle chest can injure a nerve and weaken the vocal cords, which may result in hoarseness. Air leaks from the lung that occur after the mediastinoscopy can require additional treatment with a chest tube, which will need to remain in place for a few days.
Any biopsies taken during the procedure will take a few days to complete and results will be reported by the doctor, probably at a follow-up office visit.
Last modified: September 22 2008.
