What is Mediastinoscopy

Mediastinoscopy is a procedure that checks two areas:

• The lymph nodes around your airway (trachea).
• The area where the trachea splits into the large air passages (major bronchi) that go to each lung.

This procedure may be done to check for diseases of the lymph nodes or to see if lung cancer has spread to the lymph nodes (staging).

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Bleeding.
• Injury to nerves.
• Vocal cord paralysis.
• Collapsed lung.
• Infection.
• Allergic reaction to medicines.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Plan to have someone take you home from the hospital or clinic.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotic medicine to help prevent infection.
• Do not smoke before the procedure as told by your health care provider.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
• During the procedure:
  • A small incision will be made just above the breastbone (sternum).
  • A thin, flexible tube with a tiny camera and a light on the end of it (mediastinoscope) will be inserted and used to look at the area.
  • Tissue samples from lymph nodes around the airway may be taken out (biopsy) so they can be checked.
  • The incision will be closed with sutures (stitches).
  • A bandage (dressing) will be placed over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• Do not drive for 24 hours if you were given a sedative.
• You may be given medicine for pain.
• It is up to you to get the results of your procedure. Ask your health care provider, or the department that is doing the procedure, when your results will be ready.

Mediastinoscopy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Slight pain in the incision area.
• Sore throat.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures) in place. These skin closures may need to stay in place for 2 weeks or longer.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Activity

• Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider says that it is safe.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative). Do not drive until your health care provider approves.
• Limit your activities as told by your health care provider.

General instructions

• Do not take baths, swim, or use a hot tub until your health care provider approves.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.
• It is up to you to get the results of your procedure. Ask your health care provider, or the department that is doing the procedure, when your results will be ready.

Contact a health care provider if:

• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have a fever.

Get help right away if:

• You have a rash.
• You have trouble breathing.
• You have chest pain or shortness of breath.