Article and Video CATEGORIES

Cancer Journey

Search By

Lung Cancer Video Library - What Is a Mediastinoscopy?
Thu, 03/24/2016 - 06:00
GRACE Videos and Articles


Another question we often get is, “what is mediastinoscopy?” Mediastinoscopy is a very old procedure, it was invented in the early ‘50s by Dr. Carlens in Sweden and it is a very accurate method for us to assess whether or not the tumors have spread outside of the lung into the lymph nodes in the middle part of the chest, as I usually tell them, along the sternum or the windpipe, under the sternum.

Mediastinoscopy requires general anesthesia but it’s an outpatient procedure, it takes about 15 minutes to do with a small incision in the neck — I reassure them that the incision is closed with a running plastic surgery stitch so it’s usually, in a week or two, not even visible. The mediastinoscopy is painless but it does allow us to get tissue on all of the lymph nodes on the same side as the tumor, as well as the other side of the trachea from the tumor. This really is important in staging the patient. We have sort of a red line in surgery — if a patient has involvement of lymph nodes on the contralateral side, or the other side, that usually means that they are out of bounds for surgery. If they have lots of lymph nodes involved in the mediastinum, that usually means they’re out of bounds for surgery and so for us it’s a very important decision point in their surgical questioning.

Now there are two points that can happen — mediastinoscopy can be done by itself, which a lot of surgeons do, where the patient comes in and goes home the same day, or it could be done as a stage procedure, which we often do to save time. The patient is put to sleep, they have the mediastinoscopy, we get the pathology to look at the results immediately, and then go right on to the resection if the mediastinoscopy is negative. That tends to be the practice of most academic surgeons; the only ones that I do in a separate setting are the ones that have very large lymph nodes that we’re quite concerned that they may be positive, and therefore we may do those in a separate setting.

The risks for mediastinoscopy are quite low. We published a series of 3,000 that we did and had a 0.02% chance of dying within 30 days, and a 1 in 500 chance of a complication, so it’s very safe and a good procedure.

Video Language

Next Previous link

Previous PostNext Post

Related Content

Forum Discussions

Hi Stan! It's good to see you. I can only imagine what this last year has been like for you and hope the grieving is getting more manageable every day. GRACE...

It is so good to hear from you, and my sentiments are the same as Janine's.  You are definitely why we do this, and we truly appreciate your kind words.  Happiest...

Stan, thanks so much for sending this very kind note. It is because of people like you and Sara that we are so tirelessly dedicated to our mission of helping to...

Hi and welcome to GRACE.  I'm sorry mother is experiencing oligoprogrssion.  This often happens when some of the cancer cells acquire a resistance to alecensa's effects.  Those cells can be radiated...

help Mom to continue using Alectinib. Thank you for the video list as well. Is there any experience or some period in which SBRT works, is it individual or are there...

Oh yes! SBRT (Stereotactic body radiation therapy) is a very focused type of radiation that is able to target and kill the tumor without the destruction of healthy tissue. The goal...

Hi again, thank you very much for the detailed response. I hope that SBRT will help my mom and that she will use Alecensa for a long time and after Alecensa...

Recent Comments

Same EGFR G719A and S768I mutations in mom
By Beh368 on Wed, 12/07/2022 - 12:00
Good to hear from you, Stan!
By Amy B on Wed, 12/07/2022 - 09:19
Have you registered?
By JanineT Forum … on Mon, 12/05/2022 - 20:24
Thank you Stan!
By Amy B on Fri, 12/02/2022 - 14:02