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A mediastinoscopy is a surgery done to explore the inside of the upper chest between and in front of the lungs (mediastinum). This includes the heart and great vessels, the trachea (windpipe), esophagus (feeding tube), bronchi (airways leading to the lungs), and lymph nodes. This surgery is often done if your lymph nodes look swollen or large on CT scans or to check for any spread of a known cancer.
This surgery is done under general anesthesia (you will be put to sleep), and it takes 1-2 hours. Once you are asleep, a tube will be placed down your throat to keep your airway open and help you breathe. A small incision is made in the upper left chest just above your left collar bone (clavicle). Then, a small camera is placed through this small incision and into the mediastinum. Small pieces of your tissue (biopsies) are taken and sent to a pathologist who can look at them under a microscope and decide whether there is inflammation, infection, or cancer. Once the biopsy is taken, the camera and the tube in your throat are removed, and you are woken.
You will be taken to the recovery room. You will be watched for 2-4 hours as the anesthesia wears off. Most patients go home the same day. Some patients may need to stay overnight. You may have sutures (stitches), staples, or small steri-strips (small band aids) closing your skin. Steri-strips are used to keep the skin together and will fall off in 5-7 days. You may shower, but do not take a tub bath or swim until the incision is healed in 10-14 days.
Will I have pain?
You may have some discomfort or pain at the incision site. Most patients get pain relief with acetaminophen (Tylenol®) and non-steroidals (i.e., ibuprofen, Motrin®, Advil®). If you still have pain, you should call your health care provider.
Patients will be able to return to work in a week. Do not lift more 10-15 lbs. for the first 1-2 weeks.
When to Call
Bleeding from your incision
A fever over 100.4°F
Severe chest pain
Swelling in the neck or at the incision
Shortness of breath
Hoarseness of your voice that lasts more than a few days or keeps getting worse
Who to Call
If you have any questions or problems, please call the number below.
Monday-Friday, 8am – 4:30pm.
After hours, holidays and weekends, this will give you the paging operator. Ask for the Thoracic Surgery resident on call. Leave your name and phone number with the area code. The doctor will call you back.
If you live outside the area, call toll-free at 1-800-323-8942.