Loop electrical excision procedure: Difference between revisions

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The '''loop electrosurgical excision procedure''' ('''LEEP''') is one of the most commonly used approaches to treat high grade [[cervical dysplasia]] ([[Cervical intraepithelial neoplasia|CIN]] II/III, [[High grade squamous intraepithelial lesion|HGSIL]]) and early stage [[cervical cancer]] discovered on [[colposcopy|colposcopic]] examination. In the UK, it is known as '''large loop excision of the transformation zone''' ('''LLETZ'''). It is considered a type of [[Cervical conization|conization.]]<ref>{{Cite journal |date=2022-12-22 |title=Loop Electrosurgical Excision Procedure (LEEP): Pre-Procedure, Technique, Post-Procedure |url=https://emedicine.medscape.com/article/1998067-overview?form=fpf}}</ref> It has been in use since the 1970s, after its invention by Dr. Sheldon Weinstein. <ref>{{Cite web |title=Loop Electrosurgical Excision Procedure (LEEP) {{!}} Embryo Project Encyclopedia |url=https://embryo.asu.edu/pages/loop-electrosurgical-excision-procedure-leep |access-date=2023-11-16 |website=embryo.asu.edu}}</ref>
 
LEEP has many advantages including low cost and a high success rate.<ref>{{cite web |url=http://www.webmd.com/cancer/cervical-cancer/loop-electrosurgical-excision-procedure-leep-for-abnormal-cervical-cell-changes |title=Loop electrosurgical excision procedure (LEEP) for abnormal cervical cell changes |access-date=2016-11-27}}</ref> The procedure can be done in an office setting and usually only requires a [[local anesthetic]], though sometimes IV sedation or a [[general anesthetic]] is used.<ref>{{cite web |url=http://lib-sh.lsuhsc.edu/fammed/atlases/leep/leepadv.html |title=Advantages of LEEP |access-date=2007-12-28 |last=Mayeaux |first=E.J. Jr.|url-status=dead |archive-url=https://web.archive.org/web/20060904092302/http://lib-sh.lsuhsc.edu/fammed/atlases/leep/leepadv.html |archive-date=2006-09-04 }}</ref> Disadvantages include reports of decreased sexual satisfaction <ref name=":0" /> and potential for [[preterm labor]], though a meta-analysis published in 2014 suggested that in patients with existing CIN lesions as opposed to controls, the risk is not more than their baseline risk.<ref name="pmid24785601" /> Approximately 500,000 LEEP procedures are performed in the U.S. annually. <ref>{{Cite journal |last=Sklavos |first=Martha M. |last2=Spracklen |first2=Cassandra N. |last3=Saftlas |first3=Audrey F. |last4=Pinto |first4=Ligia A. |date=2014 |title=Does Loop Electrosurgical Excision Procedure of the Uterine Cervix Affect Anti-Müllerian Hormone Levels? |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3953513/ |journal=BioMed Research International |volume=2014 |pages=875438 |doi=10.1155/2014/875438 |issn=2314-6133 |pmc=3953513 |pmid=24707500}}</ref>