Mediastinoscopy
Objective
In cases of suspected malignancy:
• Endoscopic visualization of the mediastinum (tracheobroncheal junction, bronchi, aortic arch and regional lymph nodes)
• Biopsy if required.
Position
Supine.
Anesthesia
General.
Procedure
1. Transverse incision over the suprasternal notch and extended down to the pretracheal fascia.
2. Blunt dissection the superior mediastinum is entered.
3. Scope is passed.
4. Avoid injury to nearby blood vessels.
5. Lymph node tissue biopsied.
6. Hemostasis is achieved.
7. Scope is removed.
8. Wound is closed.
Instrument
• Mediastinoscope (Fig. 19.11)
• Electrosurgical unit
• Suction
• Fiberoptic light source
• Basin set
• Blade (1) No. 15
• Telfa dressing pads and 22 gauge needle
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