Awake laser surgery

I am often questioned about the safety of in-office procedures in the course of my own practice and there has been an increased concern in the wake of Joan Rivers’ passing. While patient concern is natural, tens of thousands of procedures are performed daily in physicians’ offices with a high degree of safety and at a lower cost to patients. In my personal practice, I often perform vocal fold injections, voicebox biopsies, and numerous diagnostic evaluations of the vocal folds and trachea, which are well tolerated by patients. It is important to select appropriate patients for procedures under local anesthesia and to counsel them appropriately about expectations. And, with all procedures, it is critical to have a plan in place to deal with any complications that may arise. For procedures that cannot be performed in-office, ambulatory surgical centers are an excellent alternative. They provide a full anesthesia staff and have nearly all of the capabilities of a hospital. Although the Joan Rivers incident has taught everyone to always practice with a high degree of caution, it should not deter patients or physicians from delivering high quality, efficient care in both the office and operative room setting.