Mediastinoscopy

This test is done to:

• Look for problems of the lungs and mediastinum, such as sarcoidosis.
• Diagnose lung cancer or lymphoma (including Hodgkin disease). It is often done to check lymph nodes to see if you should have lung removal surgery to treat lung cancer. Treatment may include surgery, radiation, or chemotherapy.
• Diagnose certain types of infection, such as tuberculosis.

Remove glasses, contact lenses, and dentures or a removable bridge just before the test. You'll be asked to take off your jewelry.

Before the surgery, an intravenous (I.V.) line will be placed in a vein to give you fluids and medicines. After you are asleep, a tube will be placed in your throat to help you breathe.

The doctor will make an incision just above your breastbone at the base of your neck or on the left side of your chest near the breastbone. The scope will be inserted through the opening. Your doctor will look at the space in your chest between your lungs and heart. Lymph nodes or abnormal tissue will be collected for testing. After the scope is taken out, the incision will be closed with a few stitches and covered with a bandage.

After the test, you will be taken to the recovery room. You may feel sleepy for several hours.

Some people may go home if they can swallow fluids without gagging or choking. Others may need to stay in the hospital for 1 or 2 days.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure to ask what may be done, such as lymph nodes being biopsied or removed, for each possible biopsy result.
• Your doctor may order certain blood tests, such as a complete blood count or clotting factors, before your procedure.
• Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.