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:
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.
Complications
Although complications are extremely rare, you should call your doctor if you develop any of the following concerning symptoms:
Fever
Nausea
Foul-smelling discharge
Worsening pain
Severe bleeding or clotting (going through more than one sanitary pad per hour)
The LEEP Procedure: What to ExpectWhen 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.
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Frequently Asked Questions
Is spotting normal after undergoing a procedure?
Spotting after a procedure is normal and expected. It may occur as a result of the manipulation of the cervix during the procedure. However, if the spotting is excessive or persists, it is essential to contact your doctor to rule out any potential complications.
How does anesthesia affect recovery times?
Anesthesia can impact recovery times by minimizing pain and promoting relaxation during outpatient surgical procedures like LEEP. The use of Nitrous Oxide ("laughing gas") may help reduce discomfort and anxiety, contributing to a smoother and potentially faster recovery process for patients.
Can fertility be maintained after excision?
Fertility preservation after excision depends on the extent of tissue removed. Discuss with your doctor preoperatively to understand potential impacts on future fertility.
Are cramps a common postoperative symptom?
Postoperative cramps are common. Monitor symptoms post-surgery and consult your doctor if severe.
How soon can one resume exercise?
After a LEEP procedure, most individuals can resume light exercise within a few days to a week. Consult your doctor for specific guidance based on your individual recovery progress.
What follow-up is needed post-procedure?
Following a LEEP procedure, post-procedure follow-up may involve monitoring for symptoms such as fever, nausea, foul-smelling discharge, worsening pain, or excessive bleeding. It is essential to contact your physician if any concerning symptoms arise. Regular check-ups will help ensure proper healing and recovery after the procedure.
Are there dietary restrictions post-surgery?
After surgery, follow any dietary restrictions provided by your surgeon. Heal by eating nutritious foods that aid recovery and hydration. Discomfort, bloating.
How are abnormal cells detected pre-surgery?
Abnormal cells are detected pre-surgery through PAP test results that show abnormal precancerous cells in cervical tissue (cervical dysplasia). Biopsy and examination are performed to identify the abnormal tissue requiring removal during the LEEP procedure. Nitrous Oxide may be used to minimize pain and anxiety during the process.
Can procedures cause menstrual cycle changes?
Some procedures may affect the menstrual cycle, causing changes like irregular periods or spotting. It's essential to consult with your doctor for personalized information regarding the impact of specific procedures on your menstrual cycle.
What distinguishes procedures from traditional biopsies?
Procedures like LEEP remove abnormal cells with surrounding tissue for a clear margin. Unlike biopsies, this minimizes cancer risk. Nitrous Oxide is used for pain and anxiety during the procedure. Call your doctor for concerns like fever, pain, or bleeding.
Are stitches required after excising tissue?
Stitches are typically required after removing tissue during a LEEP procedure to ensure proper healing and reduce the risk of complications. Your doctor will determine the need for stitches based on the size and location of the excised tissue.
How quickly do results become available?
Results from a LEEP procedure become available once the abnormal tissue is removed and analyzed by a pathologist, typically within a week or two. It is essential to follow up with your doctor after the procedure for the results and further guidance.
Does excision affect cervical mucus production?
Excision of abnormal cells in the cervix during a LEEP procedure can potentially affect cervical mucus production. This can result in changes in cervical mucus consistency, which may impact fertility and natural lubrication. It's essential to consult with your healthcare provider for personalized information and guidance.
Is discharge after procedures cause for concern?
Foul-smelling discharge after gynecological procedures should be examined by a doctor for possible infection or complications. If discharge is accompanied by fever, nausea, severe pain, or excessive bleeding, seek medical attention promptly to address any potential issues.
How do procedures detect precancerous conditions?
Procedures detect precancerous conditions by removing abnormal cells and surrounding healthy tissue to achieve a clean margin, reducing cancer risks. Nitrous Oxide may be used for pain and anxiety management during the process. Contact the doctor for complications like fever, foul-smelling discharge, or severe bleeding post-procedure.
Can procedures trigger early menopause signs?
Certain gynecological procedures, like a hysterectomy or oophorectomy, can induce early menopause symptoms due to hormonal changes. Discuss with your healthcare provider for personalized information regarding your specific situation.
Are procedures advisable for nulliparous women?
It is crucial to consult with a skilled gynecologist to determine the necessity of procedures for nulliparous women. The decision should be based on individual health needs and risks.
Do excisions require a hospital stay?
Excisions for outpatient gynecological procedures generally do not require a hospital stay. Most excisions, such as LEEP procedures, can be performed on an outpatient basis, allowing patients to return home the same day. Recovery and follow-up care can typically be managed at home or in a clinic setting.
Are procedures performed under local anesthetic?
Procedures like the Outpatient LEEP Procedure (cold knife cone) can be performed under local anesthetic, with options like Nitrous Oxide to minimize pain and anxiety during the process. Complications are rare, but specific symptoms should prompt contacting the doctor for further evaluation.
Can procedures prevent cancer recurrence effectively?
Procedures like the LEEP procedure aim to remove abnormal cells to reduce the risk of cancer. While not foolproof, they can be effective in preventing cancer recurrence by ensuring clean margins. Regular follow-ups are essential for monitoring.
Are there age limits for procedures?
Age limits for procedures vary based on individual health conditions and specific needs. It is essential to consult with a healthcare provider to determine the appropriateness of any procedure based on the patient's overall health and medical history.
How do procedures affect Pap smear results?
Procedures can impact Pap smear results by identifying abnormal precancerous cells, prompting the need for further removal. A LEEP procedure aims to eliminate these cells and surrounding tissue to reduce cancer risk. Complications are rare but should be reported promptly for care.
Can one travel immediately after excision?
It is recommended to avoid traveling immediately after a LEEP procedure to allow for proper healing and reduce the risk of complications. It's best to follow your doctor's advice and plan travel accordingly to ensure a smooth recovery process.
Are there non-surgical alternatives to procedures?
Non-surgical alternatives may be available depending on the specific condition. Consult with our experts to explore all options before deciding on a procedure.
How does one prepare for procedures?
Preparing for procedures involves understanding the process, following pre-op instructions, arranging for transportation, discussing concerns with the surgeon, and ensuring you have all necessary paperwork and clear directives. Following these steps ensures a smooth experience and optimal recovery.
What pain relief is recommended post-procedure?
Your doctor may recommend over-the-counter pain medications like ibuprofen or acetaminophen for pain relief post-procedure. It's essential to follow your doctor's instructions carefully and avoid strenuous activities to aid in a smooth recovery.
Can procedures detect HPV subtypes accurately?
Some procedures can detect specific HPV subtypes with accuracy, aiding in diagnosing cervical dysplasia. The LEEP procedure, for instance, targets abnormal cervical cells for removal, reducing the risk of cancer development. Consult with experienced OB/GYN specialists for comprehensive advice.
Are procedures limits on tissue removal?
Procedures for instance the LEEP procedure are aimed at removing abnormal cells along with a margin of healthy tissue, aiming to leave behind a clean margin. The objective is to reduce the risk of cancer development.
Can abnormal bleeding occur after procedures?
Abnormal bleeding can occur after procedures.
How to care for biopsy sites post-procedure?
After a biopsy procedure, patients must keep the area clean and dry, avoid strenuous activity, and refrain from using tampons or having sex for a few weeks. Contact your doctor if you experience fever, nausea, foul-smelling discharge, worsening pain, or excessive bleeding.
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