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Caring for the health of your nose and sinuses
Caring for the health of your nose and sinuses

Local Anaesthetic Rhinological Surgery (LARS)


Sinus surgery can be performed either under general anaesthetic, where you are asleep or, for certain procedures in the right patient, under local anaesthetic.

My patients that have had LARS (Local Anaesthetic Rhinological Surgery) tell me that the experience was no different to a visit to the dentist.




Although I am a very experienced sinus surgeon, LARS was not something I thought I could incorporate into my practice.

For me to be convinced this was a useful innovation that could benefit my patients, it was essential that the surgery I perform was not compromised.

I thought completeness of surgery would be limited by:

However, none of this turned out to be true.

LARS is a technique I travelled to Kansas, USA to learn. I observed Dr Doug Cowan of ENT Associates of Greater Kansas City perform a number of local anaesthetic procedures. Frankly, I was amazed by what I saw and what was possible.

I had always limited my local anaesthetic procedures to polypectomy in patients that were either unfit (respiratory or cardiac problems, sleep apnoea) or unsuitable for a general anaesthetic (pregnancy).

The difference now though is that I have technology, better medications and the perfect environment at The Wilmslow Hospital that can support the surgery I perform.

Advances include:


If you have a sinus problem or nasal congestion and think you may need an operation but are worried about a general anaesthetic or its after-effects, you should contact Mr Bhalla (01625 430550 / 07507 782188 or april@managedmedical.co.uk) to discuss your symptoms and treatment options to see whether you could be suitable for LARS.