Video-assisted Mediastinoscopy

WHAT YOU SHOULD KNOW:

• A video-assisted mediastinoscopy is a procedure which uses a videoscope to look inside your mediastinum. The mediastinum is the space inside your upper chest between and in front of your lungs. It contains the heart, large blood vessels, trachea (windpipe), esophagus (food pipe) and lymph nodes. 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.
  
  
• A video-assisted mediastinoscopy is used to find infections, or help caregivers learn if you have conditions such as sarcoidosis. It is also used to see how bad lung cancer is, or collect tissue samples from lymph nodes or tumors (growths). A videoscope is used for this procedure. It is a long bendable tube with a tiny camera on the end. The scope gives caregivers a clear view inside your chest while watching the images on a screen. Having the procedure 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 video-assisted 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.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

During your procedure:

For the procedure, you will lie on your back, and your neck will be tilted back. A caregiver cleans your chest and neck area, and put clean sheets on you. A small incision (cut) is made in your neck. Caregivers separate the tissues under your skin and insert a videoscope inside the cut. Caregivers direct the videoscope to see organs or collect tissue samples. The videoscope is pulled out and the incision is closed with stitches.

After your procedure:

• You are 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 placed over your stitches will help keep the area clean and dry, and help prevent infection. A caregiver may remove the bandage soon after your procedure to check the area.
  
  
• Medicines: You may be given the following medicines:
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.