Mediastinotomy Transcervical

In surgery, the concept of transcervical mediastinotomy is understood as the formation of a surgical wound between the parietal and visceral pleura of the abdominal cavity, separated by the diaphragm, allowing to achieve the maximum possible approach to the mediastinal organs.

To perform a transcervical dissection of the mediastinum and periosteum in the cervical spine, first an arcuate incision is made along the intertracheal distance to the level of the VI–VII cervical vertebrae, after which a lateral semicircular incision of the stomach or jugular vein is made, then a detachment of the tissue, the upper part of the pleura of the anterior surface of the cervical spine and chest. With the help of large bleeding, a transverse incision or the application of hemostats is used to inspect the mediastinal organs; if necessary, a section of the esophagus, trachea or the peripheral part of the mediastinal pleuraorta is resected.

Transcervical mediastinotomy is performed only when the lateral part of the mediastinum is affected, with mediastinitis, pleural empyema, tumors of the visceral layer of the pleura of the middle part medial to the pericardium, hilar lymphogranulomatosis of the lung, to reduce pressure, scarring in the pleural cavity of atelectatic areas of the lung, adhesions in the area of ​​the anastomosis of the bronchus and pulmonary artery, epithymia of the brain with increased intracranial pressure. Transceracocaryotic approach for surgical interventions for mediastinal cancer, laparoscopic diagnostic approach and for substructural lesions of the lungs.