Loop Electrosurgical Excision Procedure
(LEEP, LLETZ—Large Loop Excision of the Transformation Zone, LLEC—Large Loop Excision of the Cervix, Loop Cone Biopsy of the Cervix)
Loop electrosurgical excision procedure (LEEP) uses a thin wire loop to cut out areas of the cervix. The cervix is the lowest part of the uterus. The Loop allows precise cuts.
Reasons for Procedure
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Belly cramping
- Future pregnancy problems (there is a small increased risk of premature birth and having a low birth weight baby)
- Not removing enough abnormal tissue
- Harm to nearby structures
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The care team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
- Sanitary napkins to use after the procedure.
The doctor may give local anesthesia—the area will be numbed.
Description of the Procedure
A speculum will be inserted into the vagina. This tool will separate the vaginal walls. This will allow the cervix to be viewed. Anesthesia will be applied to the cervix to numb the area.
A solution will be applied to the area. It will highlight abnormal cells. A thin wire will be inserted into the vagina toward the cervix. The wire will remove the abnormal tissue. The tool heats the area to stop bleeding from blood vessels. A paste may also be applied to stop bleeding.
How Long Will It Take?
LEEP only takes a few minutes.
Will It Hurt?
There may be cramping during LEEP.
At the Care Center
When you are ready, you can go home.
It will take a few weeks for the area to fully heal. Sexual activity will need to be avoided during that time. Most can return to other normal activities in a few days.
Problems to Look Out For
Call the doctor if you are not getting better or you have:
- Heavy bleeding—more than a normal period
- Bleeding with clots
- Severe belly pain
- Fever or chills
- Unusual odor or discharge
If you think you have an emergency, call for medical help right away.
- Leung, S.O.A., Vitonis, A.F., et al. Loop electrosurgical excision procedure in managing persistent low-grade abnormality or human papillomavirus positivity. Journal of Lower Genital Tract Disease, 2021; 25 (4): 281-286.
- Loop electrosurgical excision procedure (LEEP). EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/loop-electrosurgical-excision-procedure-leep.
- Loop electrosurgical excision procedure (LEEP). The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/womens-health/faqs/loop-electrosurgical-excision-procedure.
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