Mediastinoscopy

What you should know

• A mediastinoscopy is a procedure which uses a scope to look inside your mediastinum. The mediastinum is the space inside your chest between and in front of your lungs. It contains the heart, large blood vessels, trachea (windpipe), esophagus (food pipe) and lymph nodes. A mediastinoscopy is used to look at these organs and structures, find infection, or see how bad lung cancer is. It can also be used to collect samples of lymph nodes or tumors (growths). Lymph nodes are small organs found in your neck and the rest of your body. They have special cells that fight off infection, swelling, and cancer. Lymph nodes may swell (get bigger) if you have an infection or illness.
  
  
• You may need a standard, anterior, or extended mediastinoscopy. A mediastinoscopy may help caregivers learn what is causing your signs and symptoms. It may also help caregivers see how well treatments are working, and if other treatments should be started.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

You may have an allergic reaction to the anesthesia medicine. You may get an infection or bleed more than expected. Your caregiver may need to do other procedures to stop the bleeding. You may get blood clots or air in your chest cavity. Arteries (blood vessels) and nerves may be injured. After the procedure, your voice may be hoarse if the nerve from your voice box is hurt. Caregivers will watch you closely for these problems. You may need to have a mediastinoscopy done more than once. If you do not have the procedure, your condition may get worse. Call your caregiver if you are worried or have questions about your procedure, medicine or care.

Getting Ready

The week before your procedure:

• Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• Tell your caregiver if you have arthritis in the bones of your neck. If you are a female, tell your caregiver if you know or think that you might be pregnant. Tell caregivers if you have a problem with blood clotting.
  
  
• You may need to have a CT scan, PET scan, and other tests done before the mediastinoscopy. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your procedure:

• Remove any nail polish.
  
  
• You may be given medicine to help you sleep.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your procedure. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before the procedure. You may need to check your blood sugar more often before and after having your procedure.
  
  
• Ask caregivers about directions for eating and drinking.

The day of your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
  
  
• Do not wear tight-fitting clothes on the day of your procedure or surgery.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

You will be asked to change into a hospital gown. You will be brought on a stretcher to the operating room. You will be given medicine called general anesthesia to keep you asleep during the procedure. For the procedure, you will lie on your back, and your neck will be tilted back. A caregiver will clean your chest and neck area, and put clean sheets on you. A small incision (cut) will be made in your neck. Caregivers will separate the tissues and insert a mediastinoscope inside the cut. A mediastinoscope is a thin tube with a light on the end. Caregivers direct the scope to see organs or collect tissue samples. The scope will be pulled out and the incision will be closed with stitches.

After your procedure:

You will be taken to a room where you can rest. Caregivers will check on you. When they see that you are ready, you may be able to go home. If you are staying in the hospital, you will be taken to your hospital room. Do not get out of bed until your caregiver says it is OK. A bandage will cover your stitches. This bandage keeps the area clean and dry to help prevent infection. A caregiver may remove the bandage soon after your procedure to check the area.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your procedure on time.
  
  
• You have a fever.
  
  
• You have a skin infection or a wound on your chest or neck.

Seek Care Immediately if

• Your condition, or signs and symptoms are getting worse.
  
  
• You have sudden trouble breathing.