Mediastinal Surgery

The mediastinum is a group of structures in the middle of the chest. It includes the heart, the large blood vessels to and from the heart, the oesophagus, the trachea (windpipe), nerves, the thymus, and lymph nodes.

The mediastinum is broadly divided into three compartments — an anterior (front) one containing the thymus and lymph nodes, a middle one containing the heart & major blood vessels, and a posterior (back) one containing the oesophagus, trachea & nerves.

The term ‘Mediastinal Surgery’ usually refers to surgery performed in the anterior mediastinum, typically to biopsy or remove either the thymus or lymph nodes, or a tumour that may have developed in this area.

The thymus is a small organ in the upper mediastinum, just behind the sternum. It functions as part of the immune system and is particularly important in childhood and adolescence. By adulthood, it has usually lost activity and become essentially a mass of fat. Tumours can arise in the thymus, or occasionally removal of the thymus may be recommended to treat myasthenia gravis, an autoimmune condition causing muscle weakness.

Surgery on the mediastinum can be performed through a number of different approaches, including via the sternum, through the lower part of the neck, or using VATS via one or both sides of the chest.