Loop Electrosurgical Excision Procedure
(LEEP)

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Medical Author:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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• Loop Electrosurgical Excision Procedure (LEEP) Overview
• LEEP Preparation
• LEEP Procedure
• LEEP Post-procedure
• LEEP Risks and Complications
• Next Steps
• Follow-up
• Outlook
• Synonyms and Keywords
• Author and Editor

Loop Electrosurgical Excision Procedure (LEEP) Overview

Loop electrosurgical excision procedure (LEEP) is a technique used in the treatment of mild to moderate precancerous changes (dysplasia) of the uterine cervix (cervical dysplasia). The cervix is the base of the womb (uterus) that leads out to the birth canal (vagina). LEEP can sometimes also be used to treat severe dysplasia or cancers that have not invaded into the deeper tissues of the cervix (known as carcinoma in situ).

With the LEEP technique, a low voltage electric current is used to cut away the abnormal tissues. Unlike techniques that destroy the abnormal tissue (such as laser or freezing), the abnormal tissue is retained after LEEP, allowing for microscopic examination by a pathologist.

LEEP generally does not have significant risks or side effects, but mild pain, cramping, and vaginal bleeding can occur. LEEP is also sometimes referred to as large loop excision of the transformation zone (LLETZ).

LEEP Preparation

LEEP is performed after the precancerous changes of the cervix have been identified through screening tests and cervical biopsies. Typically, findings on the screening Pap test will signal that further examination of the cervix is necessary. Colposcopy is the examination of the vulva, vaginal walls, and uterine cervix using illumination and magnification in order to detect and examine abnormalities of these structures. Colposcopy is performed to evaluate abnormal Pap test results. During colposcopy, further testing, including biopsies (sampling of abnormal-appearing areas for examination by a pathologist) are performed to determine whether cancer or precancerous changes are present.

If dysplasia confirmed through colposcopy and/or biopsies, treatment options, including LEEP, are considered.