How is LEEP (loop electrosurgical excision procedure) performed?

LEEP begins much like a regular pelvic exam. Though you will remain awake throughout the procedure, you should feel only minor discomfort. First, you will be asked to lie back and rest your feet in stirrups at the end of the examination table. A speculum will be inserted into the vagina and opened so that the cervix can be seen.


Positioning for loop electrosurgical excision procedure

A very dilute solution of acetic acid or Lugol’s solution (Iodine) is applied to the cervix to make the abnormal cells visible. Your physician then places a colposcope near the opening of the vagina. The colposcope, which remains outside of the vagina, provides a magnified view of the cervix.

The cervix is then numbed with local anesthesia. This may cause tingling in the tongue, ringing in your ears or a rapid heart rate. If this occurs, it lasts for only a few minutes. Once the cervix is numb, an electrically charged loop made of thin wire is inserted through the speculum and up to the cervix.

As the loop is passed across the cervix, it cuts away a thin layer of surface tissue, removing the abnormal cells. Sometimes a second loop is used to go a little higher up the cervix. This tissue will be later tested for cancer or abnormal cells as well as proximity of the abnormal cells to the edge of the tissue that was removed (the margins).

Finally, a medicated paste (an iron solution called Monsel’s paste) is applied to the area to stop and prevent bleeding.

How long does the procedure take?

The procedure takes 10 to 20 minutes to perform. You will be able to go home as soon as the procedure has been completed.

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