What is a LEEP procedure?
LEEP stands for Loop Electrosurgical Excision Procedure and involves using a narrow wand with a fine electrified wire loop at the end that is used to carefully and precisely remove a limited amount of cervical tissue which will be tested for cancer.
The objective of this procedure is to remove all abnormal cells plus a narrow margin of surrounding healthy tissue (known as obtaining a “clean margin”), so that a margin free of abnormal cells remain, thus decreasing your chance of developing cancer. The removed tissue is sent to a laboratory for testing.
What is a Cold Knife Cone Biopsy?
This procedure involves using a scalpel or laser to remove a large cone-shaped segment of tissue from your cervix that contains abnormal cells plus a narrow margin of surrounding healthy tissue. The removed tissue is sent to a laboratory for testing to identify any precancerous cells and/or cancerous cells.
Why is a LEEP Procedure or a Cold Knife Cone Biopsy performed?
When a PAP test is performed, your doctor takes a sample of tissue from your cervix in order to screen for abnormal precancerous cell changes that can develop into cervical cancer.
If your doctor informs you that your PAP test results show abnormal precancerous cells in your cervical tissue (a situation known as cervical dysplasia), the next step is to remove any abnormal tissue surrounding the biopsy site. This is done in order to make sure that all abnormal cells are removed, thus reducing your risk of these cells becoming cancerous.
There are two different procedures for removing abnormal cervical tissue and both are performed on an out-patient basis at our Surgery Center:
- A LEEP procedure
- A Cold Knife Cone Biopsy
How is a LEEP done?
The procedure is performed in our surgical suite. You are positioned lying on your back with your feet in stirrups. After your surgeon inserts a speculum to open your vagina and visualize your cervix, a local anesthetic will be injected into your cervix. This is known as a cervical block.
If needed, the cervical block will be combined with oral or intravenous pain medication to make the procedure as comfortable as possible. In addition, Nitrous Oxide (aka “laughing gas”) may be used to not only greatly minimize pain, but also to help with anxiety.
The LEEP wand will be passed through your vagina and into your cervix and will be used to extract the abnormal tissue plus a small margin of surrounding healthy tissue (a lesion removal technique known as obtaining “clean margins”) with the goal of removing all abnormal tissue with the potential to progress into cancer.
An electrical current is run through the fine LEEP wire as it passes through the tissue in order to cauterize the area and seal the blood vessels to minimize bleeding. You will hear humming and/or blowing sounds from the equipment during your procedure. You may experience slight pressure or cramping.
The entire procedure will take from 20 to 40 minutes, after which you will be taken to the recovery area and monitored until your anesthesia wears off. You will then be able to go home with your designated driver.
How is a Cold Knife Cone Biopsy done?
As with the LEEP procedure, the procedure will be performed in our surgical suite. You will be positioned on your back with your feet in stirrups. Your surgeon will inject local anesthesia to numb your cervix. Oral or intravenous pain medications may be given to make you more comfortable. Nitrous oxide (aka “laughing gas”) may also be provided to minimize pain and anxiety.
Next, your surgeon will insert a speculum into your vagina to gain access to your cervix. A surgical knife or a laser knife will be used to remove a cone-shaped sample of cervical tissue. This tissue will be sent to the lab to be evaluated for signs of cancer.
Recovery from a LEEP Procedure or a Cold Knife Cone Biopsy
It is not uncommon to experience some of the following unpleasant symptoms after a LEEP or Cold Knife Cone Biopsy:
- Mild cramping: is usually managed with ibuprofen or using a heating pad
- Dark brown vaginal discharge: is oxygenated blood from the surgical site inside your cervix
- Vaginal discharge: that can last anywhere from one to three weeks
It is important to refrain from sexual intercourse and from inserting anything into your vagina for 3 to 4 weeks after surgery because it puts you at risk of developing an infection or complication. You should use sanitary pads instead of tampons to absorb bloody discharge.
Douching is not recommended.
You will return for a follow-up visit 3 to 4 months after your procedure. Your surgeon may want to perform a repeat PAP smear at that time to monitor your cervix. Generally speaking, women who undergo a LEEP procedure will need more frequent PAP testing.
Although complications are extremely rare, you should call your doctor if you develop any of the following concerning symptoms:
- Foul-smelling discharge
- Worsening pain
- Severe bleeding or clotting (going through more than one sanitary pad per hour)
When it comes to gynecologic surgery, there is no substitute for experience
Dr. Thais Aliabadi and Dr. Ramon Yera are recognized experts with an international reputation in minimally invasive OB/GYN surgery, having performed thousands of out-patient procedures over twenty years. The recipients of dozens of awards for medical excellence and patient satisfaction, Drs. Aliabadi and Yera have joined forces to create the Outpatient Hysterectomy Center, a world-class surgical practice dedicated exclusively to women’s reproductive health.
At their state of the art facility in Beverly Hills, Doctors Aliabadi and Yera specialize in leading-edge minimally invasive surgeries that offer patients shorter recovery times, less pain and the least interruption to their daily lives. They are pleased to work with a team of highly experienced, dedicated professionals who will help make your pre and post-procedure experience as pleasant and stress-free as possible.
If you are considering gynecologic surgery, you owe it to yourself to learn about the minimally invasive surgical treatment options available today. Schedule a consultation today to have a candid conversation with one of our surgeons about your particular condition in a discreet and non-intimidating setting, where they can address all of your questions and explore what surgical procedure might be most suitable for you.
If you wish to schedule a consultation to learn how we can help you or to establish care with us, please request a consultation online or call us at 844-541-7900.