There are two types of procedure:
1. Traditionally, a dacrycocystorhinostomy is performed with an incision in the skin on the side of the nose, close to the eye. Some bone is removed so a tube can be inserted through the lacrimal sac and into the nose. This tube is then left in place to prevent the gap from closing and is removed after a few months.
2. Endoscopic dacrycocystorhinostomy, a thin, flexible tube (endoscope) is inserted into the nose along with surgical instruments. An opening is then made in the lacrimal sac from inside the nose, avoiding external scarring. In some cases, a stent may be used for a period of time to maintain the opening.