When performing a mediastinotomy, the surgeon makes a two-inch incision into the center of your chest cavity (the mediastinum) to evaluate and remove tumors in your heart and lung area. This procedure is often performed with a mediastinoscopy, in which the physician inserts a lighted instrument (mediastinoscope) to view the area and take a tissue sample. You will be required to fast in advance and refrain from driving following the procedure.