Mediastinoscopy
View other tests
What is the
test?
Mediastinoscopy is a surgery that allows doctors
to view the middle of the chest cavity and to
do minor surgery through very small incisions.
It allows surgeons or pulmonary doctors to remove
lymph nodes from between the lungs and to test
them for cancer or infection. It is also useful
for examining the outside surface of the large
tubes of the airways (such as the trachea) or
for evaluating tumors or masses in the middle
chest.
Back to top >
How
do I prepare for the test?
Discuss the specific procedures planned during
your mediastinoscopy ahead of time with your
doctor. This procedure is done by either a surgeon
or a trained pulmonary specialist. You will need
to sign a consent form giving your surgeon permission
to perform this test.
If you are taking insulin, discuss this with
your doctor before the test. If you take aspirin,
nonsteroidal anti-inflammatory drugs, or other
medicines that affect blood clotting, talk with
your doctor. It may be necessary to stop or adjust
the dose of these medicines before your test.
It is likely that you will be able to go home
the same day as the surgery, but you will need
to arrange for someone else to drive you home.
This is because you will have received medicines
that can leave you drowsy for some hours after
the procedure.
You will be told not to eat anything for at
least eight hours before the surgery. An empty
stomach helps prevent the nausea that can be
a side effect of anesthesia medicines.
Before the surgery (sometimes on the same day),
you will meet with an anesthesiologist to go
over your medical history (including medicines
and allergies) and to discuss the anesthesia.
Back to top >
What
happens when the test is performed?
Mediastinoscopy is done in an operating room.
You wear a hospital gown and have an IV (intravenous)
line placed in your arm so that you can receive
medicines through it.
This procedure is almost always done with general
anesthesia, which puts you to sleep so you are
unconscious during the procedure. General anesthesia
is administered by an anesthesiologist, who asks
you to breathe a mixture of gases through a mask.
After the anesthetic takes effect, a tube is
put down your throat to help you breathe. One
reason you need this tube is that your head is
tilted far back during the procedure. The tube
keeps your throat safely open even while your
neck is bending backwards.
A very small incision (less than an inch long)
is made above your breastbone (sternum). Carbon
dioxide gas is allowed to flow into your chest
through this opening, while your lungs are made
to slightly collapse, giving your doctors a space
within which to work. A tiny camera on a tube,
called a mediastinoscope, is then inserted through
the opening. Your doctor can see the work he
or she is doing by watching a video screen.
The doctor makes one or two other small incisions
to allow additional instruments to reach into
your chest. These incisions are usually made
next to your sternum, between ribs. A wide variety
of instruments are useful in mediastinoscopy.
These include instruments that can clip away
a lymph node and remove it through one of the
small chest incisions. Other instruments can
be used to stop bleeding blood vessels by using
a small electrical current to seal them closed.
At the end of your surgery, the instruments
are removed, the lungs are reinflated, and the
small incisions are stitched closed. The anesthesia
is stopped so that you can wake up within a few
minutes of your procedure, although you will
remain drowsy for a while afterward.
Back to top >
What
risks are there from the test?
You will have a small straight scar (less than
an inch long) wherever the instruments were inserted.
You may have some discomfort for a few days in
the areas of the incisions. Sometimes work in
the middle chest can temporarily injure a nerve,
which can weaken your vocal cord muscles for
a while and cause hoarseness. In rare cases,
bleeding complications might require a transfusion
or larger chest surgery. Air leaks from the lung
can also occur and occasionally require additional
treatment such as a drainage tube, called a chest
tube, that is placed into the chest between your
ribs and left there for a few days.
General anesthesia is safe for most patients,
but it is estimated to result in major or minor
complications in 3%-10% of people having surgery
of all types. These complications are mostly
heart and lung problems and infections.
Back to top >
Must
I do anything special after the test is over?
You should notify your doctor if you experience
fever, shortness of breath, shoulder pain, or
chest pain. You should not drive or drink alcohol
for the rest of the day.
Back to top >
How
long is it before the result of the test is
known?
Your doctor can tell you how the surgery went
as soon as it is finished. If biopsy samples
were taken, these often require several days
to be examined.
Back to top >
View
other tests |
HOME
MY
CART
