Mediastinoscopy: Before Your Procedure

Lungs in chest and mediastinal space between lungs, with detail showing possible incision sites above or left of breastbone.

What is mediastinoscopy?

Mediastinoscopy (say "mee-dee-yass-tuh-NAW-skuh-pee") is a procedure that looks at the space behind your breastbone and between your lungs. This area is called the mediastinum (say "mee-dee-ya-STY-num").

During the test, a doctor makes a small cut (incision) in the neck just above the breastbone. Sometimes the cut is made on the left side of the chest next to the breastbone. Then the doctor places a lighted tube into the cut. The tube lets the doctor look around inside that space.

This test is done to look for problems such as infection, inflammation, or cancer. The doctor may use the tube to take a sample of tissue from the area. This is called a biopsy. The sample can then be looked at under a microscope for problems.

This procedure usually takes about an hour.

How do you prepare for the procedure?

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

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    Be sure to ask what may be done, such as lymph nodes being biopsied or removed, for each possible biopsy result.
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    Your doctor may order certain blood tests, such as a complete blood count or clotting factors, before your procedure.
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    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.
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    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.
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    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.
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    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.
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    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.

What happens on the day of the 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.
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    Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
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    Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
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    You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
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    The procedure will take about an hour.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your procedure.
  • You become ill before the procedure (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the procedure.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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