Loop Electrosurgical Excision Procedure (L.E.E.P.), also known as Large Loop Excision of the Transformation Zone (LLETZ) is a 10-minute surgical procedure that removes pre-cancerous uterine cervical tissue.
The procedure is typically done with only a local anesthetic; however, patients may opt to have a "twilight" IV sedation.
A thin wire loop dissects the tissue by transfering a special high-frequency electrical current through the tissue. Bleeding is controlled with a special ball electrode and a Ferric subsulfate solution.
The doctor will perform a colposcopy if he detects abnormal cervical cells in a PAP smear. A colposcopy simply involves looking at the patient's cervix under a microscope during an exam. If a colposcopy or lab test confirms moderate to severe dysplasia (a pre-cancerous change on the skin or cervix), the doctor will recommend that the patient have L.E.E.P.
Prior to the procedure, Family Planning Center requests that each patient attend a brief counseling session so that she clearly understands:
All other medical options (other than L.E.E.P.) that remove abnormal cervical cells (for example, cryosurgery)
The results and possible complications of the L.E.E.P. procedure
The patient is encouraged to wash her genital area thoroughly with a mild soap and water. Shaving the pubic region is not necessary.
The procedure begins with the patient undressing from the waist down and lying on the table with a d**** over her waist. The doctor inserts a speculum (just like a PAP smear) into the **** and numbs the cervix with several local injections. The injections are not painful because there are very few nerve endings in the cervix; and, many patients describe them as little bee stings. While the anesthesia is numbing the cervix, the doctor places an electrosurgical dispersive pad on the patient's leg to complete the current from the electrical loop. When the cervix is numb, the doctor carefully inserts the wire loop (which is located on the end of a long thin rod) through the speculum and slices through the cervix to remove the abnormal cells. The loop is very precise and allows the doctor to remove the abnormal tissue with a small amount of healthy tissue to ensure that all of the abnormal cells are removed. The procedure is quite painless; however, the patient might experience mild cramping afterwards.
The final result is a healthy cervix with no dysplasia. The tissue that was removed is sent to a lab to ensure that all abnormal cells are removed. Some patients will experience light bleeding, mild discomfort, and or a small amount of brownish-black discharge.
Patients should return to the office for a follow-up exam within four weeks to make sure that the cervix healed properly. Also, patients should return for PAP smears every 3-6 months over the next two years to make sure the dysplasia does not return.
The L.E.E.P. procedure is very simple and safe. Therefore, complications from L.E.E.P. are very unusual. However, it is possible that a patient might experience:
Excessive scarring of the cervix
Inability to carry a baby to term
Removal of too much tissue
Post Operative Instructions
Family Planning Center endorses fast and healthy recovery for every patient having an in-office surgery. Patients having L.E.E.P. should follow the post-operative instructions below and call the clinic if they experience any complications.
Do not have sexual intercourse for the length of time recommended by your physician.
Do not insert anything into your **** for two weeks (including tampons, douche, and intercourse).
Take showers (not baths) for the first two weeks.