mediastinotomy
mediastinotomy
[me″de-as″tĭ-not´ah-me]me·di·as·ti·not·o·my
(mē'dē-as'ti-not'ŏ-mē),mediastinotomy
(mē′dē-ăs′tə-nŏt′ə-mē)mediastinotomy
A minimally invasive surgical procedure used to gain direct access to mediastinal structures for visualisation and biopsy.Indications
Lesions or suspected lesions of the mediastinum which are inaccessible by mediastinoscopy; idiopathic mediastinal widening; cancer staging; confirmation of TB or sarcoidosis.
Complications
< 3%; haemorrhage, pneumothorax, vocal cord paralysis, oesophageal perforation.
Method
Anterior mediastinotomy is performed on either the left or right side; a transverse incision is made over the 2nd costal cartilage, which is removed entirely; the internal mammary vessels are divided, and the mediastinal pleura is deflected laterally, to allow entry into the extrapleural space; if needed, the excision can be extended to increased pulmonary and mediastinal access.