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Mediastinal tumour surgery
Condition Guide

Mediastinal tumours
Minimally invasive thymectomy & tumour resection

The mediastinum is the space in the middle of your chest, between the lungs — it holds the heart, the windpipe, the food pipe and the thymus gland. Growths here are often not cancer, but they need to be checked and sometimes removed. Dr. Irshad removes most of them through small keyhole cuts rather than opening the breastbone.

Thymectomy / resection
Procedure
2–3 days
Hospital stay
Keyhole
Minimally invasive
~6 weeks
Full recovery

What is a mediastinal tumour?

It’s a growth in the central chest. Common types include thymomas (from the thymus gland), cysts, enlarged lymph nodes and germ-cell tumours. Many are not cancer. Surgery often both removes the growth and provides the exact diagnosis.

Signs & symptoms

  • Many cause no symptoms and are found on a scan
  • Chest pressure or pain
  • Cough or shortness of breath
  • In some cases, muscle weakness linked to myasthenia gravis (with thymus tumours)

Many of these growths are found by chance on a scan done for another reason. See your doctor about ongoing chest pressure, a lasting cough, breathlessness, or new muscle weakness.

How it’s diagnosed

  • CT and/or MRI scans
  • Blood tests for certain tumour markers
  • Sometimes a needle biopsy
  • Surgery may be the clearest way to both diagnose and treat

Treatment options

  • Minimally invasive thymectomy (removing the thymus)
  • Keyhole removal of cysts and masses
  • Coordinated oncology care if the growth is cancerous
Dr. Irshad’s approach

Robotic & keyhole mediastinal surgery

Rather than opening the breastbone (a sternotomy), Dr. Irshad removes most mediastinal growths through a few small cuts. He increasingly uses the surgical robot for these resections — its 3D, high-definition magnified view and wristed instruments are especially valuable in the deep, confined space of the mediastinum, working safely around the heart, the great vessels and the phrenic nerves.

The result is precise removal of the growth with less pain, a shorter hospital stay and a faster recovery than open surgery — while still removing it completely and confirming the diagnosis.

Why a robotic approach helps here

A clear, magnified view

The robot gives a 3D, high-definition view that magnifies the deep, narrow mediastinum, so delicate structures are seen far more clearly than with the naked eye.

Wristed precision

Instruments that bend like a human wrist allow fine, controlled dissection in a tight space — right next to the heart, great vessels and phrenic nerves.

Complete removal

Excellent visualization helps remove the whole growth — and the entire thymus when needed, which matters in conditions such as myasthenia gravis.

Smaller cuts, faster recovery

A few keyhole incisions instead of splitting the breastbone means less pain, a shorter hospital stay, and a quicker return home.

Your recovery, step by step

Before surgery

Prehab helps: stopping smoking and doing daily breathing exercises lowers your risk and speeds recovery.

Hospital

2–3 days for most minimally invasive mediastinal resections.

Weeks 1–2

Light activity; avoid lifting; care for the incisions.

Weeks 3–4

Gradual return to normal activity; pathology results reviewed.

6 weeks

Follow-up, with an oncology referral if needed.

Common questions

What types of growth occur in the mediastinum?
The mediastinum has three areas, and different growths tend to sit in each. In the front: thymomas (from the thymus gland), lymphoma, and germ-cell tumours. In the middle: cysts and enlarged lymph nodes, often near the windpipe. Toward the back: neurogenic tumours, which grow from nerve tissue. Many are not cancer, and the location helps point to the likely diagnosis even before surgery.
What is myasthenia gravis, and how is it linked?
Myasthenia gravis (MG) is an autoimmune condition where the immune system disrupts the signals between nerves and muscles, causing muscle weakness that gets worse with use — often affecting the eyes, face, swallowing, or limbs. The thymus gland in the chest plays a role in MG, so removing it (a thymectomy) can improve symptoms, even when there is no thymus tumour.
I have myasthenia gravis but no thymoma. Should I still have a thymectomy?
Yes, in most cases. A landmark trial (the MGTX study) showed that removing the thymus significantly improves outcomes in myasthenia gravis even without a thymoma, and can reduce the need for immune-suppressing medication.
Is a mediastinal mass always cancer?
Not at all. Many are benign cysts, mature teratomas or low-grade thymomas. The type, location and imaging features guide the workup. A tissue diagnosis is often needed, which surgery provides definitively.
Will I need a large incision?
Usually not. Most mediastinal growths can be removed through a few small keyhole cuts, which avoids dividing the breastbone and speeds up recovery.

Preparing for your surgery at William Osler

Your operation takes place at William Osler Health System (Brampton Civic Hospital). These are the hospital’s general instructions for getting ready, the day itself, and afterwards — always follow any specific advice Dr. Irshad gives you. Full details are on the Osler Surgical Services page.

Before your surgery
  • Do not eat anything (including gum) after midnight the night before. Unless told otherwise, you may have clear fluids — water, pulp-free juice, black coffee or tea — up to 2 hours before.
  • No alcohol, smoking, or marijuana for 24 hours before surgery.
  • Shower the evening before and the morning of surgery (with chlorhexidine soap if you have it). Skip lotion, perfume, makeup and nail polish.
  • Bring your OHIP card and photo ID, all your medications in their original containers (inhalers, insulin, supplements), and your CPAP machine if you use one.
  • Arrange a responsible adult to drive you home — a taxi, Uber or Lyft does not count, and surgery may be cancelled without one.
  • Leave jewellery, money and valuables at home.
The day of your surgery
Arrive about 2 hours before your scheduled time. Register at the central registration desk in the main lobby at Brampton Civic Hospital (2100 Bovaird Drive East), then go to the Day Surgery area. Staff will help you change, check your vitals, confirm the details from your pre-anaesthesia visit, and start an IV before you go to the operating room. Your family member can wait in the surgery waiting area.
After your surgery
You’ll wake up in the Post-Anaesthesia Care Unit, then move to Day Surgery or an inpatient room (or the Intensive Care Unit if you need closer monitoring). For the first 24 hours after the anaesthetic, have an adult with you, do not drive or operate machinery, avoid alcohol, and hold off on big decisions. A follow-up appointment is booked before you leave. Learn more about discharge and pain management.
The pre-anaesthesia clinic
Before your operation you’ll get a call from the pre-anaesthesia clinic for an education call or an in-person visit, where the team reviews your health, your medications and your anaesthetic plan.

Medically reviewed by Dr. Kashif Irshad, MD, MSc, FRCSC · Last updated July 2026

A referral from your family doctor or specialist is all that’s needed to be seen by Dr. Irshad. Find the referral forms and clinic details below.

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