Large Loop Excision of the Transformation Zone (LLETZ) - Leep

LEEP, or loop electrosurgical excision procedure, is the removal of a piece of the cervix, which is the neck of the uterus. This is done by passing electricity through a thin loop of wire, which cuts and seals the tissue being removed.

Who is a candidate for the procedure?

This procedure is done on women whose Pap smears show abnormal changes in the cells of the cervix. These changes may lead to cancer. The most appropriate candidates for LEEP are women with so-called high-grade changes, which represent very disorganized areas of tissue in the cervix.

LEEP is not done on women who have cancer that has already invaded the cervix.

How is the procedure performed?

LEEP only takes a few minutes. Usually, it is done in the office of a healthcare provider.

First, the cervix is injected with a local anesthetic and medication that makes the blood vessels contract to avoid blood loss. The wire loop is then passed across the cervix. It removes the area between the outer and inner portion of the cervix, which is called the transformation zone. Most cervical problems develop in this area.

The wire loop cuts and seals the tissue it passes through. The size of the piece removed depends on the size of the wire loop used.

The tissue sample is then sent to the lab to be examined under the microscope.

What happens right after the procedure?

After the procedure, a woman should report severe bleeding or any other problems she has been warned of to her doctor. Other problems may include abnormal vaginal discharge, fever or severe pain. Some mild discomfort or dull pain may be present for a few days afterward.

What happens later at home?

Douching and sexual intercourse should be avoided for at least 2 weeks or until the patient has a follow-up visit with her doctor or healthcare provider.

What are the potential complications after the procedure?

Bleeding and infection are the major complications of LEEP. These occur rarely.

Author:Carlos Herrera, MD
Date Written:
Editor:Coltrera, Francesca, BA
Edit Date:04/20/00
Reviewer:Adam Brochert, MD
Date Reviewed:09/19/01

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