Mediastinoscopy

Overview :

Mediastinoscopy is usually performed in a hospital under general anesthesia. An endotracheal tube is inserted first, after local anesthesia is applied to the throat. Once the patient is under general anesthesia, a small incision is made usually just below the neck or at the notch at the top of the breastbone. The surgeon may clear a path and feel the patient's lymph nodes first to evaluate any abnormalities within the nodes. Next, the physician will insert the mediastinoscope through the incision. The scope is a narrow, hollow tube with an attached light that allows the surgeon to see inside the area. The surgeon can insert tools through the hollow tube to help perform biopsies. A sample of tissue from the lymph nodes or a mass can be extracted and sent for study under a microscope or on to a laboratory for further testing.

In some cases, analysis of the tissue sample which shows malignancy will suggest the need for immediate surgery while the patient is already prepared and under anesthesia. In other cases, the surgeon will complete the visual study and tissue extraction and stitch the small incision closed. The patient will remain in the surgery recovery area until it is determined that the effects of anesthesia have lessened and it is safe for the patient to leave the area. The entire procedure should take about an hour, not counting preparation and recovery time. Studies have shown that mediastinoscopy is a safe, thorough, and cost-effective diagnostic tool with less risk than some other procedures.