A mediastinoscopy is a minimally invasive procedure a surgeon uses to see your mediastinum (area between your lungs). They use a scope that has a light and camera to look for cancer. They can use a tool on the scope to take tissue samples and remove lymph nodes. This gives providers the information they need to decide if lung cancer spread.
A mediastinoscopy (MEE-dee-uh-sty-NOS-koh-pee) is a surgical procedure that lets a healthcare provider see inside your mediastinum, which is between your lungs. This area includes your heart, esophagus and trachea (windpipe).
Providers use a mediastinoscope to view the area. This tool is a thin tube that has its own light and camera. Also, it has the ability to take out a tissue sample, lymph node (part of your immune system) or mass.
Healthcare providers use both of these procedures to look at your mediastinum and take samples or lymph nodes from it. They also use these procedures to find out if diseases, including cancers, spread in the area.
A mediastinotomy makes an opening, while a mediastinoscopy uses a scope and a smaller incision. Surgeons can reach more areas when they use a mediastinotomy, but the incision is larger and the recovery time is longer.
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You may need a mediastinoscopy if your provider wants a better look at the area between your lungs. They might want to remove or take a sample of your lymph nodes in this area to look for cancer. Also, they can check the stage (severity) of cancer in your lung, thymus gland or esophagus.
Yes. People with certain conditions shouldn’t have a mediastinoscopy. These include people who:
A cardiothoracic surgeon or general surgeon performs a mediastinoscopy in an operating room. The surgeon needs to be able to open your chest (sternotomy) or do a thoracotomy (cut between your ribs) as a backup option if they need to control more bleeding than expected.
Preparing for a mediastinoscopy procedure starts days before your scheduled test. You need to:
Yes. You should be able to go home the same day as your mediastinoscopy. Before you go home, your provider will want you to be able to:
There are many mediastinoscopy procedure steps. Your provider will:
A mediastinoscopy takes about an hour. However, sometimes it can take more time if your provider needs to do more exploring or sampling, or if they encounter complications that require a change to a sternotomy or thoracotomy.
After you wake up from the general anesthesia, you’ll still feel sleepy for a few hours. Your relative or friend can drive you home if you’re not having any issues after your mediastinoscopy. You can’t drive yourself home after you’ve had anesthesia.
You can expect to have numbness in your mouth and throat for a few hours. This is a result of the breathing tube that providers use for giving breaths. For your safety, your provider won’t let you drink or eat during this time. You may have a cough, hoarseness or a sore throat the next day, and pain where your provider made an incision.
You may need a chest X-ray to make sure you don’t have any lung issues after your mediastinoscopy.
Yes. You can expect to need to take pain medicine for a few days after your mediastinoscopy.
Most of the time, people don’t have mediastinoscopy complications. However, some people can have:
The mortality rate for a mediastinoscopy is .09%.
Bleeding is a complication that happens more often than any other.
Information from your mediastinoscopy procedure will allow your provider to use a cancer staging system to describe your cancer. The stage tells how large a tumor is and whether it spread.
Contact your provider if you have any of these after you go home:
A note from Cleveland Clinic
Knowing what to expect can help you feel more at ease before having a procedure for the first time. Ask your healthcare provider questions about anything you don’t understand about a mediastinoscopy. Be sure to get any scans your provider needs beforehand and follow instructions about preparing for your procedure.
Last reviewed by a Cleveland Clinic medical professional on 08/02/2022.
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