Mediastinoscopy

Mediastinoscopy (abbreviation: MSK or MESK ) is an endoscopic surgery of the middle mediastinum. It is performed under general anesthesia ( anesthesia ) using a special endoscope ( mediastinoscope ). In this method, so it is a so-called minimally invasive surgery of the area between the two lungs " mediastinum Area" ( mediastinum ).

Usually, the mediastinoscopy is nowadays performed as Videomediastinoskoskopie. In the video mediastinoscopy the surgical field is displayed on a monitor, allowing a better view and an up to 15 -fold magnification. In classical mediastinoscopy has only the surgeon perspective in the surgical area.

Indications for this surgical exploration are eg histological examination enlarged lymph nodes, which is done with a biopsy or lymph node extirpation during mediastinoscopy. This diagnosis can then be made. This frequently happens in the diagnosis of lung tumors, such as non-small cell lung carcinoma ( NSCLC) and the assessment of the tumor stage, since we derive implications regarding therapy. Other indications for mediastinoscopy are suspected of having sarcoidosis, malignant lymphoma, or mesothelioma.

The mediastinoscopy go mostly preliminary investigations such as chest X-ray, computed tomography ( CT), magnetic resonance imaging ( MRI) or positron emission tomography ( PET) advance to increase the accuracy of lymph node staging and minimize the risk to the patient. For although the MSK has a low risk in experienced hands, injury to vessels or nerves ( recurrent laryngeal nerve ) with a resultant vocal cord paralysis or a violation of the pleura but (with the development of pneumothorax ) is possible and there is, as with any invasive procedure the risk of Keimeinschleppung and thus an infection of the mediastinum ( mediastinitis ).

With the extended mediastinoscopy the examination process is extended over the aortic arch addition to the left to make it accessible to the para-aortic lymph node of a clarification.