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Mediastinotomy is a surgical procedure in which a small opening is created in the upper chest to access the mediastinum – the space between the lungs. This central chest area contains the heart, major blood vessels, trachea, bronchi, lymph nodes, lymph vessels, and the thymus gland.
The mediastinum is divided into three parts – anterior, middle, and posterior – and mediastinotomy allows doctors to carefully examine these structures and take a biopsy if needed.
In Israel, mediastinotomy is performed by leading thoracic and oncologic surgeons in top hospitals, under strict international medical standards, ensuring both accuracy and safety for patients.
Why is Mediastinotomy Performed?
Mediastinotomy is mainly done to diagnose or exclude diseases that affect the chest and lymph nodes, such as:
- Lung cancer and chest tumors
- Hodgkin lymphoma and non-Hodgkin lymphoma
- Sarcoidosis (an inflammatory disease of the lungs, lymph nodes, liver, or spleen)
- Infections (including tuberculosis)
It is also used to check whether lung cancer has spread to mediastinal lymph nodes or organs, which is crucial for staging and planning treatment.
⇒ Consult with Top Cardiothoracic Surgeon
⇒ Consult with Top Lung Cancer Doctor
Preparing for the Procedure
Before mediastinotomy, patients are usually advised to:
- Stop eating and drinking 8–10 hours before surgery.
- Pause certain medications about a week before the procedure (based on doctor’s instructions).
The surgery is done under general anesthesia and typically lasts 30 minutes to 2 hours. Most patients stay in the hospital for about 24 hours after the procedure. In some cases, doctors recommend monitoring for 1–2 days to ensure safe recovery.
Mediastinal Biopsy
A mediastinal biopsy can be performed during mediastinotomy to take tissue samples for:
- Assessing the stage and spread of lung cancer
- Diagnosing lymphomas, sarcoidosis, tuberculosis, and other chest conditions
In many cases, Israeli doctors prefer minimally invasive techniques such as:
- EBUS (endobronchial ultrasound) – biopsy via the trachea
- EUS (endoscopic ultrasound) – biopsy via the esophagus
These methods reduce the need for open surgery and allow faster recovery.
Surgical Approaches to the Mediastinum
Depending on the condition, different surgical techniques may be used:
- Video-assisted thoracoscopy (VATS) – tiny cameras and instruments are inserted through small chest incisions.
- Video-assisted mediastinoscopy – performed through a small incision at the base of the neck.
- Mediastinostomy – rarely used; incision near the sternum.
Mediastinal Tumors and Treatment
Large tumors in the mediastinum (such as thymomas, teratomas, lymphomas, or cysts) can press on vital structures like the trachea or heart vessels, creating serious anesthesia risks.
In such cases, Israeli surgeons take special precautions, sometimes avoiding general anesthesia and using local methods when possible. If the tumor is very large, chemotherapy or radiation may be used first to shrink it before surgery.
Thymus and Thymus Surgery
The thymus gland, located behind the sternum, plays a role in immune system development during childhood and can sometimes give rise to tumors (thymomas).
Thymectomy (removal of the thymus) is performed in patients with thymoma and sometimes in those with myasthenia gravis to improve their condition.
Minimally invasive thymectomy (thoracoscopy) is an option for small tumors.
For larger or invasive thymomas, a full sternotomy (opening of the chest bone) may be necessary.
Israeli surgeons are highly experienced in complex thymus surgeries, often combining resection of nearby tissues to ensure complete tumor removal while maintaining safety.
Mid-Sternotomy
Mid-sternotomy is a surgical incision through the middle of the chest, commonly used for complex cases when tumors press on the trachea or major blood vessels. In Israel, doctors make every effort to use the least invasive approach possible, sometimes starting with biopsy under local anesthesia or using pre-treatment to reduce tumor size before surgery.
Why Choose Israel for Mediastinotomy?
- World-class thoracic surgeons with experience in complex mediastinal diseases.
- Advanced diagnostic technology (PET-CT, MRI, EBUS, molecular testing).
- Minimally invasive options wherever possible, reducing pain and recovery time.
- Multidisciplinary care – thoracic surgeons, oncologists, radiologists, and anesthesiologists collaborate to ensure the safest outcomes.
Mediastinotomy in Israel is a safe and effective procedure for diagnosing and treating diseases of the chest and mediastinum. Thanks to advanced surgical techniques, world-class specialists, and personalized treatment approaches, patients receive care that meets the highest international standards.
Frequently Asked Questions
- What is mediastinotomy?
It’s a surgical opening in the chest that allows doctors to examine and biopsy the mediastinum – the space between the lungs. - Why is it needed for lung cancer?
Mediastinotomy helps determine if cancer has spread to the lymph nodes or other mediastinal organs, which guides treatment. - Is mediastinotomy painful?
The procedure is done under anesthesia. Mild discomfort may be felt during recovery, but Israeli hospitals use advanced pain management methods. - How long is the recovery?
Most patients go home after 24 hours, though some may stay 1–2 days for monitoring. - Are there alternatives?
Yes, in many cases minimally invasive methods such as EBUS or EUS biopsies can be performed instead of surgery.
