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The treatment of recalcitrant plantar verrucae has represented challenging clinical problems for podiatric physicians. A procedure described by Borovoy et al studying 46 patients initially indicated a success rate of 76.1%. A review of 200 patients who have been treated with refined treatment protocols and modalities is presented, with an overall success rate of 79.9%. The Candella SPTL 1 and 1B have been used in the study. These lasers produce a full 450-microsecond pulse at 585 nm wave length. Hand pieces ranging from 2 mm to 7 mm were used. The energy density (fluence) used ranged from 6 to 9 J/cm2. Discussion will be presented including treatment protocol, modalities, comparisons with other forms of treatment, and overall success rates.

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The use of the laser has become a well-recognized means of treating obstructing lesions of the tracheobronchial tree. Patients with lower airway compromise are in a precarious state of equilibrium. Everything done by the endoscopy-anesthesiology team tends to change this balance. Cooperation and coordination of this well-disciplined team is needed for efficient treatment of difficult cases. This paper outlines our surgical techniques, which have been tempered and modified to an anesthetic technique that provides the greatest safety with comfort. We detail the basic anesthetic methods for drug usage, pulmonary ventilation, and patient monitoring that we now use. A careful analysis of our results is presented to show that this technique does provide relatively safe anesthesia in this difficult setting.