A very stimulating procedure, so the patient is likely to move if not in a deep enough anesthetic. For this reason, some will use paralytics. However, this is a very quick procedure, so dose the paralytics judiciously and/or make sure a reversal is drawn up and ready. Positioning - Positioning varies. Lithotomy is common, but the surgeon may prefer prone with a slight-moderate jackknife position.
This procedure is a first-line treatment for any large ( greater than 1 cm) protruding anogenital wart. General anesthesia is usually indicated for extensive excision (beyond the superficial dermis) of large, bulky warts. Carbon dioxide lasers may be used if the surgeon decides laser therapy is necessary. Reoccurrence is found in approximately one-third of patients that undergo this surgery. Pain can be expected to last one to four weeks.
