Day Care Procedure Research Articles

Ganglion impar neurolysis in chronic perineal pain

<br><b>Background:</b> Chronic perineal pain (CPP)-mediated through ganglion impar produces complex symptoms causing functional impairment and chronic disabling persistent pain. Ganglion impar which is a solitary midline sympathetic ganglion receives afferent pain fibers from various pelvic organs mediates this type of nociception. A procedure such as ganglion impar block-neurolysis allows blockade of pain reception and mediation, providing effective pain relief. This study is aimed at analyzing the technical feasibility, safety, and efficacy of trans-sacrococcygeal ganglion impar neurolysis in patients with CPP at a rural territory care center. <b>Materials and Methods:</b> Twenty-six patients with CPP were prospectively evaluated for trans-sacrococcygeal ganglion impar neurolysis following good response to diagnostic block under fluoroscopy guidance. Numeric Pain Rating Scale (NPRS) score was observed at various time intervals. The number of attempts and procedural complications was also noted. <b>Results:</b> Out of 26 patients, 16 (62%) were of cancer origin and 10 (38%) cases of noncancer pain with a mean age of 53 and 34 years, respectively. The average NPRS score at 6 weeks in the cancer group was three, while the score was zero in noncancer group. NPRS score at presentation and at 8 weeks follow-up showed significant improvement in both groups. There was no more than a single attempt made to access ganglia through our approach. No procedural-related complications were found. <b>Conclusion:</b> Social burden of CPP, especially in the rural population, is neglected and may appear demanding both to patients and treating professionals. Transsacrococcygeal Ganglion impar block and neurolysis offer a safe, convenient day-care procedure without any significant complications. In cancerous origin of pain, neurolysis could be a good adjuvant.<br>

Penile strangulation injury in children — Reconstructive procedure and outcome

BackgroundPenile strangulation injury (PSI) is rare and is usually reported in circumcised children. Damage to Corpus Spongiosum (encasing urethra) and Corpus Spongiosum by hidden constricting material (e.g. hair or thread) in penile groove can cause Urethral Fistula (UF) and near total glans amputation. We report varied grades of PSI in children with emphasis on surgical procedure and its outcome. Patients and methodsFifteen children were treated from August 1991 to December 2018 for PSI inflicted by encircling hair (n = 4) and cotton or polyester thread (n = 11). Twelve patients with Grade 1 and 2 injury had a single stage reconstructive procedure. ResultsAge of patients ranged from 6 months to 11 years (mean 5.8 years). All the patients including two who have attained sexual maturity stated satisfactory outcomes, e.g., urinary stream on follow up (range: 1.1 to 13 years; mean 6.5 years). One patient developed urethrocutaneous fistula (UF) and had repair as a daycare procedure. ConclusionOne stage surgical repair is appropriate to manage varied damage to urethra and corpora associated with PSI. Immediate and long-term results are reasonable. Level of evidenceLevel IV.

Patient satisfaction on Trigger finger management

Trigger finger relatively a common hand problem with varied treatment options from conservative to surgical release done as outpatient and daycare procedure with its own applications and limitations. Our aim is to assess patient satisfaction among the different types of trigger finger release at different areas of health care. 60 patients (Female 60%: Male 40%) with single-digit trigger finger involvement (Ring finger28.33%, Thumb26.66%, Middle finger25%, Index finger18.33%) with a mean age of 49years were divided into four groups based on card selection. The mean Short Assessment of Patient Satisfaction SAPS score was highest amongst the group in which the procedure was done at the outpatient area under percutaneous needle release technique, while the mean lowest score was obtained from group IV in which the procedure was done at the operation theatre by open release technique as daycare. Patient satisfaction and compliance were found to be higher in the group who underwent a procedure at an outpatient area.

Management of haemorrhoids in tertiary care centre

Aim: To evaluate the outcome of sclerotherapy and closed haemorrhoidectomy.Materials & Methods: 24 patients of anorectal disease were included and were operated in this period, 7 patients underwent closed haemorrhoidectomy, 9 patients were given sclerotherapy. Patients of anorectal abscess were excluded and correction of anemia done followed by posted to surgery. Grade I and II Haemorrhoids were treated with sclerosant and Grade III and IV are treated with closed haemorrhoidectomy. Both procedures were done under spinal anesthesia.Results: 7 patients underwent closed haemorrhoidectomy and 9 patients underwent sclerotherapy. Postoperative complications in both groups were studied like pain, bleeding per rectum, mucosal discharge, urinary discharge and wound dehiscence are treated and follow up done. No case arrived with any symptoms of recurrence in the follow up of next 6 months.Conclusion: Sclerotherapy is the preferred technique for hemorrhoids (especially Grade I & II) with minimal duration of stay, early return to the work and less post operative pain and it can be done as a daycare procedure. For Grade III& IV haemorrhoids, closed hemorrhoidectomy is ideal and beneficial.

Introduction of prostate artery embolization (PAE) in Sweden

Background: Transurethral resection of the prostate (TURP) is ‘Gold Standard’ treatment for moderate-to-severe lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH) with bladder-outlet obstruction (BOO). However, TURP is associated with a risk of complications, so minimally invasive methods have been developed. Prostate artery embolization (PAE) is a new minimally invasive procedure. This study reports the outcomes of PAE when introduced in a ‘real life’ clinical setting in a Swedish County hospital.Methods: A prospective, single-center, single-arm study in a consecutive vascular-anatomy ‘all comers’ population, eligible for TURP or adenomaenukleation, but unsuitable for this, treated with PAE from January 2015 to June 2018. Defined improvement of IPSS/QoL scores, or freedom from urinary catheter if previous urinary catheter-dependent, or clean intermittent catheterization (CIC) were considered as clinically successful treatments. PAE was performed until arterial stasis using the Perfected technique. Most patients were treated during a day-care procedure.Results: Of 37 treated men, bilateral PAEs were achieved in 32 patients, unilateral PAEs in four patients, and bilateral failure in one patient due to difficult vascular anatomy. Clinically successful treatment was achieved in 84%, without serious adverse events.Conclusions: PAE was introduced in Sweden, showing PAE as a novel and good minimally invasive alternative in treatment of symptomatic BPH, possible to perform as a day-care procedure.

Basic Interventional Procedures: Practice Essentials.

There has been an increasing demand in image-guided minimally invasive procedures and these have become an integral part of present-day clinical practice. Basic interventional radiology (IR) procedures have greatly reduced the need for invasive procedures for sampling as well as treating conditions like abscess and fluid collections. Owing to their minimally invasive nature, most of these procedures may be performed on the outpatient patients as daycare procedures. Some of these procedures in critically ill patients may be lifesaving. Basic interventional radiology (IR) procedures consist of image-guided fine-needle aspiration cytology and biopsy, tru-cut (core) biopsy, needle aspiration/drainage and percutaneous catheter drainage. This review aims to provide practice requisites for basic IR procedures.

Review of the Use of Stainless Wires in Craniosynostosis Surgery.

Controversy exists as to the ideal form of bone fixation in craniosynostosis surgery with the use of resorbable plates predominating in most craniofacial units. However, the use of stainless steel wires has been the preferred fixation method at the Oxford Craniofacial Unit (OCU) since its establishment. Wires have the advantage of being malleable, inexpensive, and quick and easy to use. A retrospective review of all patients who underwent craniosynostosis surgery at the OCU between February 1995 and February 2017 was undertaken. Average follow-up period was 141 months (11.7 years), with a minimum of 6 months. A total number of 1226 craniosynostosis procedures were performed. A minimum of 16,160 wires were inserted. No complications were identified resulting from transdural migration of wires. One hundred fifty-six wires were removed in 92 patients during 109 general anesthetic day-care procedures. This was due to discomfort on palpation in the majority of cases. The average time from primary surgery to removal of wires was 37 months (3.1 years). The most common site for wire removal was in the supraorbital and lateral forehead regions, and occurred most frequently in children who had undergone fronto-orbital advancement and remodeling. The use of wires in craniofacial surgery is safe. One percent of all wires that were inserted had to be removed. Children undergoing primary craniosynostosis surgery have a 9% chance of needing a subsequent day-care procedure to have a wire removed. Taking into account the cost of this additional surgical procedure, the primary use of wires in craniosynostosis surgery is still significantly cheaper than the use of resorbable plates.

Urologic day-care surgery in a Tertiary Hospital in Nigeria: A 4-year review

Background: Day-care surgery is associated with economic, social, and health benefits to the patients. The increasing pressure on hospital bed and theater space serves as impetus for renewed interest in day-care surgery in our facility. Objective: To report our experience in day-care surgery in the past 4 years. Materials and Methods: This is a retrospective review of patients who had urologic day-care procedures in our facility, from January 2014 to December 2017. Data were collected through pro forma and analyzed using SPSS version 20.0 for windows. Results: There were 502 patients who had day-care procedures within the study period which accounted for 43.5% of elective procedures. The patients' age ranged from 1 to 90 years. There were 494 males (98.4%) and 8 females (1.6%). The procedures were diagnostic in 89.6%, therapeutic in 9.8%, and both diagnostic and therapeutic in 0.6% of the patients. The procedures included transrectal ultrasound (TRUS)-guided prostatic biopsy (74.5%), urethrocystoscopy ± biopsy and double J stent retrieval (16.7%), varicocoelectomy (2.8%), circumcision (1.4%), meatoplasty (0.6%), excisional biopsy (0.6%), and others (3.4%). Two patients (0.4%) had a conversion to inpatient admission due to persistent hematuria following urethrocystoscopy and biopsy. There were three re-admissions (0.6%) for postprostatic biopsy infection (0.4%) and surgical site infection (0.2%) following varicocoelectomy in an obese patient. Conclusion: TRUS-guided biopsy, urethrocystoscopy, and varicocoelectomy are the most common day-care procedures in our facility. The morbidity, conversion, and re-admission rates were acceptable.

Safety of Pediatric Peripheral Blood Stem Cell Harvest in Daycare Setting: An Institutional Experience.

Introduction:Children serving as a donor for their siblings will require anesthesia or sedation. In view of shortage of time and space in operating room setting, peripheral blood stem cell (PBSC) harvest is performed as a daycare procedure.Aim:This study aims to find out whether performing PBSC harvest in hematology blood collection area as a daycare procedure is safe or not.Settings and Design:This secondary analysis included 164 pediatric PBSC harvest (154 pediatric donors, of which 10 had repeat harvesting done) donors, performed under anesthesia, in the Department of Hematology, between January 2009 and June 2017.Materials and Methods:Donors were examined, informed consent was obtained, and adequate premedications were ensured. Induction was intravenous for cooperative donors or inhalational sevoflurane followed by intravenous maintenance infusion using either face mask or a laryngeal mask airway (LMA). During the procedure, vitals are monitored with a noninvasive monitor. Normal hemodynamics were ensured before transferring the children to the ward.Statistical Analysis:Statistical analysis was performed using SPSS 16.0 statistical software. Descriptive statistics and frequencies were used for the data description.Results:A total of 137 donors (median age of 5 years) were induced with sevoflurane and LMA was used in 84 children and face mask in 53. Twenty-seven children cooperated for intravenous induction. Various combinations of propofol, dexmedetomidine, and ketamine were used with respiratory and hemodynamic stability. The median duration of anesthesia was 250 (165–375) min. The recovery from anesthesia was smooth with a median wake-up time of 20 (5–60) min.Conclusion:This retrospective analysis demonstrates that nonoperating room anesthesia for pediatric age group for PBSC harvest can be safely and successfully accomplished outside the operation room setting by a consultant anesthesiologist.

Clinical study of efficacy of probing as a treatment for epiphora in adults

Background/Context: Probing is a simple operative procedure, can be performed easily in adults under local anesthesia, and is associated with minimal postoperative morbidity. The study aimed to determine the efficacy of probing in adults with epiphora due to common canalicular block (CCB) and nasolacrimal duct obstruction (NLDO). Materials and Methods: A prospective, interventional study was conducted on 44 patients with epiphora. Probing was done through upper and lower canaliculus under local anesthesia in all patients with epiphora due to CCB and NLDO. Probing was considered successful if the epiphora had been resolved or reduced to an acceptable level and if the lacrimal system was patent on lacrimal syringing for 6 months. Results: Patients comprised 36 women and eight men with the age group between 25 and 80 years who had epiphora for 3–24 months. Twenty-six patients had common CCB and 18 had complete NLDO. Complete patency was achieved in 12 and 5 and partial patency in 9 and 6 patients with CCB and NLDO, respectively. Treatment was successful in 72.72% of the patients. Ten patients underwent uneventful cataract surgery and 12 failed cases needed dacryocystectomy. Conclusion: Since probing is a simple, quick, cost-effective, and daycare procedure with low morbidity and obviates the need for further nasolacrimal surgery, probing can be recommended as an initial treatment in adults with epiphora.

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: Techniques and Challenges.

Intrathoracic lymphadenopathy is a common problem encountered in clinical practice and is caused by a wide variety of diseases. Traditionally, the mediastinal lymph nodes were sampled using conventional transbronchial needle aspiration (TBNA), or surgical methods such as mediastinoscopy, and thoracotomy (open or video-assisted thoracoscopy). However, surgical modalities including mediastinoscopy are invasive, expensive, and not universally available. Moreover, they are associated with considerable morbidity and mortality. Conventional TBNA although minimally invasive has a low diagnostic yield. In the last decade, endobronchial ultrasound-guided TBNA (EBUS-TBNA) has emerged as the diagnostic procedure of choice in evaluating undiagnosed intrathoracic lymphadenopathy. EBUS-TBNA is also currently the preferred modality in the mediastinal staging of lung cancer. The procedure is minimally invasive, safe, and can be performed as a day-care procedure. In the era of personalized medicine in lung cancer, optimizing the procedure, sample collection, and processing are crucial, as more tissue is required for performing a wide array of molecular tests. Despite its widespread use and acceptance, the diagnostic sensitivity of EBUS-TBNA is still low. To maximize the yield, cytologists and physicians should be aware of the technical details of the procedure. Herein, we discuss the technique of performing EBUS-TBNA, its indications, contraindications, and the processing of the samples at our bronchoscopy suite. We also highlight the challenges faced by the cytologists and clinicians while processing EBUS aspirates.

Incidence and risk factors for mortality in patients with cirrhosis awaiting liver transplantation

Aim: This study aimed to determine the mortality in Indian patients awaiting liver transplantation and to assess the impact of cirrhosis-related complications (CRCs) on mortality. Materials and Methods: This was a prospective study on patients of Indian origin, aged >18 years, with cirrhosis liver (confirmed by imaging and/or liver biopsy), and registered for liver transplant (LTx) between November 2015 and May 2016. Patients were followed up for at least a year. Any admission or day-care procedure for complications after registration was recorded as an event, and outcome was noted as recovered, deterioration, or death. The primary end point of the study was LTx, survival, or death. Patients undergoing transplantation were grouped with survivors for analysis of factors predicting waitlist mortality. Statistics: t-test, Chi-square test, Mann–Whitney U-test, and univariate and logistic regression analyses were used for statistical analysis. P

Effectiveness of isolated septal surgeries in nasal septal deviations: A prospective study with reference to the nasal obstruction symptom evaluation scale

Introduction: Nasal septal deviation is a common diagnosis made by an otorhinolaryngologist, and septoplasty or submucous resection is among the most common daycare procedures practiced in the clinic. Aims and Objectives: The aim of this study was to assess clinically if at all, there is any change in the symptoms of a person post an isolated septal surgery without dealing with the external contour and cosmetic appeal. Materials and Methods: One hundred patients with complaints of nasal obstruction, trouble breathing through the nose, and headache were selected for the study. The initial preoperative assessment was done based on a symptomatic score (Nasal Obstruction Symptom Evaluation Scale [NOSE]). The presence of a septal deviation (cartilaginous or bony) was confirmed with a computed tomography of the paranasal sinuses and a diagnostic nasal endoscopy. Surgery was then performed to correct the pathology based on the location of the deviation. The postoperative assessment was done after 12 weeks based on the NOSE Scale. The results were analyzed and documented. Observations and Results: It was found that the symptomatic picture was better post surgery. Conclusion: The conclusion obtained from the study was that septoplasty and submucous resection as isolated surgical procedures are still relevant in today's world for symptomatic betterment and a healthier lifestyle.

Feasibility And Efficiency Of Ureterorenoscopy As A Day-care Procedure For Treatment Of Ureteric Calculi

Objective: To assess the feasibility and efficiency of ureterorenoscopy as a day-care procedure for treatment of ureteric calculi in order to reduce their heavy workload and to spare resources for reducing long waiting list of elective advanced urological surgeries for patients admitted as an indoor category. Study design: Prospective descriptive study. Place and duration of study: The study was conducted in Urology department of PNS Shifa, Karachi from July 2017 to March 2018. Methodology: All patients who presented to our institute for ureteric calculi with normal creatinine and no urosepsis were included in the study. The ureterorenoscopy procedure was carried out either in spinal anesthesia or general anesthesia using laryngeal mask. Post-operative outcomes criteria for feasibility were assessed as ‘rate of complications that required admission in the hospital’. Results: A total of 164 patients underwent ureterorenoscopy. Out of these 151 successful ureterorenoscopy procedures for urolithiasis were performed with 98% stone clearance. Majority of patients went home the same day with no sequel, only twelve patients were kept for a day or two for minor complications. Nine of these had severe pain postoperatively requiring parenteral analgesia and were discharged on first postop day. Three had developed fever and were discharged on second postop day. No confounding factors were found to predict the readmission event. Conclusion: A day care ureterorenoscopy is a safe procedure in a full time day care setting, with a rapid turnover and clinically safe outcome with few and trivial complications requiring readmission

Safety and Viability of Totally Tubeless Ambulatory Percutaneous Nephrolithotomy (APCNL) in the Fast Paced World

Background: Percutaneous Nephrolithotomy (PCNL) is the gold standard for endoscopic management of large renal stones. Various modifications have been done to bring down the morbidity of this procedure. Ambulatory PCNL (APCNL) defines PCNL as day-care procedure, avoiding overnight hospital stay which is less than 24 hours. Totally tubeless makes faster recovery without the need for double J stent or nephrostomy tubes. This study aimed at exploring the feasibility and safety of APCNL in selective patients. It also aimed at improvising the procedure to facilitate early recovery and discharge of patients within 24 hrs. Materials ands Methods: In this study, 12 patients underwent APCNL under general anaesthesia with endotracheal intubation from April 2016 to March 2017. All the procedures were done by a single surgeon. The inclusion criteria were stone size of less than 2cm, without any co-morbidities, Computed Tomography (CT)/Retrograde Pyelogram(RGP) evidence of normal pyelocalyceal anatomy, patient staying within the radius of 15km, well informed patient. All patients underwent totally tubeless PCNL i.e. without nephrostomy, DJ stent and catheter. Skin infiltration was given with 0.25% Bupivacaine. Post operatively analgesia was given on demand (intramuscular Aceclofenac / oral Acetaminophen plus Tramadol). All patients were followed up after 2 weeks. Results: Twelve patients underwent prone PCNL. All patients had single puncture (10 lower calyx, 2 middle calyx), Amplatz size was less than 30F, size of the stone (1.3cm to 2cm) with a mean size- 1.7cm, saline used around 300ml. But, two patients were discharged after 36hrs and 48hrs due to pain. None of them returned to hospital with haematuria, pain or urinary tract infection. Conclusion: APCNL is a safe procedure in well informed selective patients. These are the patients with small burden of stone and staying close to the hospital. APCNL reduces the hospital stay, expenses and results in early return to work.

Nationwide pediatric renal biopsy audit by the Indian Society of Pediatric Nephrology

Objective: The survey was conducted to identify current renal biopsy practices in India and compare them with the British Association of Pediatric Nephrology (BAPN, 2015) standards. Methods: A 53-question survey questionnaire was sent to 48 centers across the country by electronic mail. Questions included were related to the number of biopsies performed, indications, prerequisites and procedure of biopsy, monitoring, and complications. The results were compared against the BAPN 2015 standards. Results: Thirty (62.5%) out of 48 centers responded to the questionnaire. Real-time ultrasound was the favored method at 24 (80%) centers. Most (80%) of the biopsies were performed by nephrologists alone. The biopsy was usually (80%) an inpatient procedure with overnight hospitalization; 20% of the centers performed it as a day-care procedure. The 18-gauge needle was preferred by 60% of the centers. Biopsy was achieved with three or fewer passes in 93% of the centers. Almost half (47%) of the centers considered 10 or more glomeruli on light microscopy as adequate to reach a diagnosis. The rates of gross hematuria were

Role of dexmedetomidine as an anaesthetic adjuvant in breast cancer surgery as a day-care procedure: A randomised controlled study.

Background and Aims:Breast cancer surgery can be carried out as day-care procedure to increase patient turnover, decrease disease progression and financial burden. The present study was carried out to assess the role of dexmedetomidine in breast cancer surgery as a day-care procedure.Methods:This prospective randomised, double-blind study was carried out on 100 patients screened for day-care breast cancer surgery. They were divided into two groups of 50 each; who received either normal saline (Group NS) or 0.6 μg/kg/h dexmedetomidine (Group D) infusion from 10 min before induction until skin closure. All patients were given general anaesthesia. The incidence of discharge, post-operative pain (POP), average rescue analgesia (fentanyl) required and side effects were noted. Statistical analysis was performed using Student's t-test and Chi-square test.Results:Incidence of discharge in group NS was 60% compared to 88% in Group D (P = 0.001). Average rescue analgesia requirement by group NS was 136.07 ± 43.06 μg, whereas it was 77.5 ± 29.86 μg in Group D (P = 0.01). The incidence of POP in 6 h and within 2 h of expected discharge time in Group NS was 56% and 28%, respectively, and in Group D, it was 8% in both the periods (P < 0.001 and 0.01). Side effects such as post-operative nausea, vomiting and bleeding were encountered in eight and two patients, respectively, in Group NS and two and one patients, respectively, in Group D.Conclusion:Dexmedetomidine as an anaesthetic adjuvant makes breast cancer surgery feasible on day-care basis.

Operative hysteroscopy intravascular absorption syndrome: The gynecological transurethral resection syndrome

Hysteroscopy is becoming fairly common in most centers these days, both as a diagnostic and therapeutic tool especially for short day-care procedures, reducing unnecessary hospital admissions and overuse of resources. However, these procedures are not without complications, and some could be delayed and potentially fatal if a high index of suspicion is not maintained. One such rare yet one with a high mortality among urological patients is the transurethral resection syndrome on which there is a cornucopia of literature in the form of articles and chapters. There are very few highlighting a similar syndrome of sorts called the operative hysteroscopy intravascular absorption syndrome. Here, we describe one such case, and in brief, the anesthetic management options for hysteroscopic procedures to prevent such a complication.

Comparative Study between Propofol and Dexmedetomidine for Conscious Sedation in Patients Undergoing Outpatient Colonoscopy.

Introduction:Colonoscopy is a mildly painful procedure requiring conscious sedation. Though propofol is a widely used anesthetic agent in day-care procedures due to its rapid onset and quick recovery has a drawback of requiring resuscitation maneuvers more often than the conventional methods. Dexmedetomidine, a newly introduced, highly selective α2-adrenergic receptor agonist possessing hypnotic, sedative, anxiolytic, sympatholytic, and analgesic properties with impressive safety margin, needs to be explored for use in conscious sedation for colonoscopy procedure among South Indian population.Materials and Methods:A prospective randomized comparative study was conducted on patients aged between 25 and 60 years with the American Society of Anesthesiologist physical status classes I and II posted for colonoscopy under monitored anesthesia care. Study group was randomly divided into two groups and administered propofol and dexmedetomidine. The primary outcome variable was assessments of sedation scores between the two groups. Secondary outcome variables were pain score assessments, hemodynamic comparisons, and adverse events among the two groups. Appropriate statistical tests were applied to compare the findings.Results:After comparisons between the two groups, we found that patients on dexmedetomidine had similar sedation score as that of patients on propofol. However, there was a significantly higher incidence of systemic hypotension. Requirement of rescue analgesia and adverse events and other hemodynamic fluctuation were similar in both the groups.Conclusion:We conclude that dexmedetomidine has similar efficacy as propofol for conscious sedation required during colonoscopy. Occurrence of systolic hypotension was, however, significantly more among the group receiving dexmedetomidine.

Transcanalicular Laser-Assisted Dacryocystorhinostomy With Endonasal Augmentation in Primary Nasolacrimal Duct Obstruction: Our Experience.

To evaluate and compare the success rate of transcanalicular laser-assisted dacryocystorhinostomy with endonasal augmentation, with and without intubation, in patients suffering from primary acquired nasolacrimal duct obstruction, at 1 year of follow up. A prospective, randomized interventional pilot study was conducted at a tertiary care center, in accordance with the guidelines of Declaration of Helsinki. Sixty eyes of 60 adult patients with primary acquired nasolacrimal duct obstruction were included. The participants were divided randomly into 2 equal groups (A and B-without and with bicanalicular intubation, respectively). An osteotomy was first created using 980 nm diode laser (set at 8W continuous mode) transcanalicularly and then enlarged intranasally using Blakesley's nasal forceps, followed by bicanalicular silicon intubation in group B patients. The tubes were removed at the end of 8 weeks. The ostium size was assessed endoscopically at 8 weeks and again at the end of follow up, at 1 year. A successful outcome was defined in terms of ostium patency at the end of 1 year. The results were analyzed at the end of a follow up of 1 year, using various statistical tests (p < 0.05). The mean age of the patients was 35.3 ± 15.89 years, with 23 male and 37 female patients, the 2 groups having a similar male:female ratio. An overall success rate of 90% was achieved at the end of 1 year with no statistically significant difference between the groups. Postoperative complications like tube displacement and punctal, canalicular injury were more in the intubated group. The average osteotomy size was 8.06 ± 5.4 mm at the end of 1 year. Transcanalicular laser-assisted dacryocysto rhinostomy, with endonasal augmentation, is a scarless, effective, daycare procedure, for treatment of primary acquired nasolacrimal duct obstruction with no additional advantage offered by silicone intubation.