Surgery on the vocal cords can be performed either directly in an open surgical approach (making an incision in the neck) or indirectly through an endoscopic approach (through a tube inserted into the mouth and throat).
Either procedure is performed under general anesthesia (the patient is fully asleep).

Recovery after either an open or endoscopic approach includes minimizing damage to the larynx during surgery, as well as reducing inflammation after the surgery. Therefore, your surgeon will recommend the procedure he/she feels will minimize these complications.