Right & Left Chamberlain Procedure, Steps, Biopsy | Chamberlain Procedure vs Mediastinoscopy

What is Chamberlain Procedure?

The anterior mediastinotomy, also known as the Chamberlain procedure, involves making a surgical incision in the parasternal second left intercostal gap and entering the mediastinum to execute a biopsy and establish a histological confirmation of swollen mediastinal lymph nodes and mesothoracic tumors. When it comes to determining the clinical stage of bronchogenic cancer, mediastinotomy is a very important task to perform. Although it is a minimally invasive technique, general anesthesia is required, and there are certain risks and contraindications.

Right & Left Chamberlain Procedure & Steps

The left side of the chest is frequently used for the Chamberlain procedure because it is where the aorto-pulmonary window is located. The right side is favored for the procedure in some situations. The patient receives anesthetic treatment. The skin of the chest is prepared using a solution. A small incision of two inches is created over the area where the second rib and breastbone converge. The pectoralis major muscle is reached by the incision all the way down. The second rib's cartilage also referred to as the costal cartilage, is removed after localization. After that, a cut is made in the side of the parietal pleura, which is the lining of the inside of the chest wall. The procedure is then continued into the middle of the chest, between the pulmonary artery and the aorta. It is crucial to keep the extensive blood arteries intact. From each of the aberrant lymph nodes or masses, samples must be taken. Without substituting the cartilage, the wound is then stitched up.

Chamberlain Procedure Biopsy

Lymph nodes or tumors in the aorto-pulmonary window or hilar lymph nodes on the left side of the chest can be biopsied with the Chamberlain procedure.  The region in the center of the chest bordered superiorly by the aorta and inferiorly by the pulmonary artery is known as the aorto-pulmonary window. This region is home to lymph nodes that are responsible for filtering drainage that has traveled from the left lung, and more specifically the left upper lobe. The Chamberlain procedure is helpful for staging lung cancer if it is found in the left lung and evaluating the amount of metastasis.  

Chamberlain Procedure vs Mediastinoscopy 

The Chamberlain procedure is the standard method that is used to obtain a tissue sample from the lymph nodes that are located on the left side of the chest. However, in mediastinoscopy, a region between the lungs and behind the breastbone is examined. The mediastinoscopy procedure is used to biopsy lymph nodes or masses that are located in front of or on the side of the trachea (also known as the windpipe).