Loop extrosurgical excision procedure or LEEP which is also sometimes called large loop excision of the transformation zone (LLETZ) or loop excision is a procedure. In this procedure, a small electric wired loop is used to remove tissue cells from a woman’s lower genital part (this includes both the cervix and the vagina). The electricity flowing through the wire causes it to heat up and enables it to work similar to a surgeon’s knife. The tissue cells that are cut during the procedure are intact and undamaged, which makes it a preferable choice when compared to other destructive procedures. In addition, it is also associated with a lower cost and fewer side effects.
What are The Possible Reasons For You To Undergo a LEEP?
Your healthcare provider may recommend a LEEP if there is any abnormality detected in your lower genital tract. Either this abnormality could be detected during a routine Pap smear or it could be a finding from a cervical biopsy.
In cases where there is a suspected abnormality, LEEP is used a diagnostic tool to obtain tissue samples from the cervix or vagina. These samples are then sent for biopsy to confirm the presence of cancer. In some cases, LEEP may reveal the presence of precancerous cells (cells abnormal but not cancerous), which could be an early indicator of cancer development.
In cases where there is confirmation of abnormal tissue growth, LEEP can be used to treat the condition by removing the abnormal tissue cells and allowing healthy cells to grow back in their place.
What Takes Place During the LEEP?
At your LEEP appointment, you will be asked to undress from the waist down and lie on the exam table the way you would for a pelvic exam. Your healthcare provider will use speculum to open up your vagina and expose your cervix. He may then use a colposcope (an instrument like a microscope) and place it at the opening of your vagina to better visualize the internal tissues. The vagina and cervix may be doused using either an iodine or a vinegar solution as these cause the abnormal cells to change color and these are then easier to identify. The doctor will then use a local anesthetic, so you do not experience pain during the procedure. The LEEP wire will be inserted through the speculum into the vagina and pierced through the abnormal tissues. At this time, you may experience a slight pressure that resembles a cramp. The electric current from the wire will seal the cut blood vessels and so stop the bleeding. The tissue specimens collected can then be sent for biopsy.
How Long Does It take to do a LEEP?
The time taken for a LEEP depends on why the procedure is being done in the first place. If it is done as a diagnostic aid, it will typically take between a few minutes up to 10 minutes. This is because the tool need only slice a layer of your tissues to send for biopsy.
Now in cases where the LEEP is used for treatment of an abnormal tissue growth, the duration may be longer. The total duration depends on amount and location of tissue that needs to be removed and skill of the healthcare provider. So depending upon size and shape of the wire, it may take more than one attempt to get rid of all the abnormal tissues and it may take up to 20 minutes or longer.
This procedure is generally regarded as safe, but there are patients who end up developing complications such as narrowing of their cervix, difficulty during childbirth, excessive bleeding etc. Therefore, it is advisable for the patients to talk to their healthcare provider to understand why they should undergo LEEP and if there are other alternative options that can be considered.