LEEP Introduction

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

The prevalence of premalignant cervical lesions is increasing in the United States. This problem usually occurs in women of childbearing years who may not have completed their families. 1, 2 Until recently, the choices for treatment of dysplastic cervical lesions included cryosurgery, electrocoagulation, laser vaporization or conization, knife conization, and hysterectomy. The first three are outpatient procedures and allow for the possibility of future pregnancies. However, since these are ablative therapies, no tissue is sent for pathological inspection, thus raising the possibility of missing microinvasive or invasive cancer. Conization and hysterectomy produce tissue specimens with wide margins but usually require outpatient surgery or hospitalization with general anesthesia, and hysterectomy precludes future pregnancies. These latter procedures require considerable skill.

Now, low voltage, high frequency, thin wire loop electrodes are used to remove cervical lesions. Loop Electrosurgical Excisional Procedure (LEEP) allows for the outpatient treatment of cervical lesions with good pathology specimens and low risk of affecting childbearing ability. 3


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