V.N. Krasnozhen Kazan State Medical Academy Kazan, Russia In recent years, endoscopic and/or microscopic methods for treating lacrimal duct pathology have become preferred due to a number of advantages over external approaches. Postoperative rhinostomy closure is typical for both external and endonasal approaches when performing dacryocystorhinostomy. The aim of the study was to improve the results of microendoscopic shaver dacryocystorhinostomy (MESDCR). Material and methods. From 1998 to 2004, 227 MESDCRs were performed in 225 patients with epiphora. The patients' ages ranged from 12 to 78 years. The diagnosis of nasolacrimal duct obstruction was confirmed by a number of objective examination methods. For surgical correction of lacrimal ducts, modern equipment was used - endoscopes, microlight guide for diaphanoscopy through the lacrimal bone, shaver system with a cutter-suction attachment, "bur" - attachments with coarse and fine notches, diamond coating, (ELEPS); curved scalpels, "cutting through" forceps; radio wave surgical device "Surgitron ™" (frequency 3.8 MHz) and round loop electrodes with a thin arc with a diameter of 6.35 mm., argon plasma coagulator; operating microscope. Features of the intervention were - use of a shaver system providing adequate access to the lacrimal sac; formation of a window in the area of ????the medial wall of the lacrimal cell bone, including the frontal maxillary process of at least 125 mm in size; cutting out a U-shaped flap from the wall of the lacrimal sac using a radio wave; suturing; using an endoscope at an angle of 70° for the best visibility in the area of ??the surgical field. Results. The results of dacryocystorhinostomy varied due to the improvement of the intervention technique and the experience gained by the rhinologist in performing the intervention. Thus, relapse of the disease in 2004 (44 operations) was not noted in any of the patients. Preoperative epiphora was eliminated, and the patency of the lacrimal ducts was confirmed by irrigation of the lacrimal sac 2, 4 and 6 months after the operation, which was regarded as a successful outcome of the intervention. Conclusion. The formation of a persistent rhinostomy is obviously facilitated by - compliance of the bone window size with the size of the flap from the medial wall of the lacrimal sac; atraumatic formation of a flap from the lacrimal sac using a radio wave with an emphasis on its inferoposterior parts; suturing on the marginal tissue of the lacrimal sac and the free edge of the nasal mucosa; Clear indications for MESHDCR are important; adequate therapy of chronic dacryocystitis.