The loop electrosurgical excision procedure
(LEEP) uses a thin, low-voltage electrified wire loop to cut out abnormal
tissue. LEEP can:
LEEP is also known as large loop excision of the
transformation zone (LLETZ).
A vinegar (acetic acid) or iodine
solution, which makes abnormal cells more visible, may be applied to the cervix
before the procedure is done.
LEEP is usually done at your
doctor's office, a clinic, or a hospital as an outpatient procedure. You do not
have to spend a night in the hospital.
You will need to take off
your clothes below the waist and drape a paper or cloth covering around your
waist. You will then lie on your back on an examination table with your feet raised
and supported by footrests (stirrups). Your doctor will insert a lubricated tool called a speculum into your vagina. The speculum gently spreads
apart the vaginal walls, allowing the inside of the vagina and the cervix to be
Medicine is injected to numb the cervix (cervical
block). If a cervical block is used, an oral pain medicine or pain medicine
given into a vein (intravenous, or IV) may be used along with the local
Most women are able to return to normal
activities within 1 to 3 days after LEEP is performed. Recovery time depends on
how much was done during the procedure.
Call your doctor now or seek immediate medical care if:
LEEP is done after
abnormal Pap test results have been confirmed by
cervical biopsy. LEEP may be used to treat cell changes on the cervix. These include:
LEEP is a very effective treatment
for abnormal cervical cell changes. During LEEP, only a small amount of normal
tissue is removed at the edge of the abnormal tissue area.
LEEP, the tissue that is removed (specimen) can be examined for cancer that has
grown deep into the cervical tissue (invasive cancer). In this way, LEEP can
help further diagnosis as well as treat the abnormal cells.
is as effective as cryotherapy or laser treatment. If all of the abnormal
cervical tissue is removed, no further surgery is needed, though abnormal cells
may recur in the future. In some studies, all the abnormal cells were removed
in as many as 98% of cases.footnote 1
Loop electrosurgical excision
procedure (LEEP) is less expensive and easier to perform than cone biopsy or
carbon dioxide laser treatment.
Before a LEEP procedure is done, a biopsy is done to confirm the abnormal cervical cell
If you have LEEP, you
need regular follow-up Pap tests. A Pap test should be repeated every 6
months or as recommended by your doctor. After several Pap test results are
normal, you and your doctor can decide how often to schedule future Pap
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Garcia F, et al. (2012). Intraepithelial diseases of the cervix, vagina, and vulva. In JS Berek, ed., Berek and Novak's Gynecology, 15th ed., pp. 574–618. Philadelphia: Lippincott Williams and Wilkins.
Samson SA, et al. (2005). The effect of loop electrosurgical excision procedure on future pregnancy outcomes. Obstetrics and Gynecology, 105(2): 325–332.
ByHealthwise StaffPrimary Medical ReviewerSarah Marshall, MD - Family MedicineFemi Olatunbosun, MB, FRCSC - Obstetrics and GynecologyKathleen Romito, MD - Family MedicineAdam Husney, MD - Family MedicineSpecialist Medical ReviewerKirtly Jones, MD - Obstetrics and Gynecology
Current as ofFebruary 20, 2015
Current as of:
February 20, 2015
Sarah Marshall, MD - Family Medicine
& Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology & Kathleen Romito, MD - Family Medicine & Adam Husney, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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