E.J. Mayeaux, Jr., M.D.
Associate Professor of Family Medicine
Clinical Associate Professor of Obstetrics and Gynecology
Louisiana State University Medical Center - Shreveport, Louisiana
Historically, hot cautery has been used since the beginning of recorded history. Electrocautery (using an electric probe to cause a therapeutic burn) came into use in the 18th and 19th centuries. In 1906, Hunner reported that electrocauterization could be used to prevent cervical cancer. Later, large-scale studies demonstrated that prophylactic electrocautery prevented cervical cancer. These studies basically used "soldering irons" to produce this electrocautery. In 1928, Hyams developed an electrode to perform a "hot wire cone biopsy." Unfortunately, this method produced major thermal artifact and had significant late bleed and cervical stenosis problems.
Physicians have experimented with high frequency current for excisions since the 1940s. It was in the mid 1980s in France, however, that Cartier started using small loops (5 by 5 mm) for cervical biopsies and excisions. 4 Prendiville experimented with larger loops with insulated cross-bars and published his first paper on 'Large Loop Excision of the Transformation Zone' in 1989. 2 The availability of modern high frequency generators has accelerated its use.
LEEP historically has been called Diathermy Loop Treatment, Loop Excision of the Transformation Zone (LETZ), and Large Loop Excision of the Transformation Zone (LLETZ), and these terms still can be found in the literature. Although several names are used today, LEEP or Loop Electrosurgery are the most commonly used terms.
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LSUMC-S Family Medicine. Write to us if you have comments or questions! EMayea@lsuhsc.edu