• Loop Electrosurgical Excision Procedure

    (LEEP, LLETZ—Large Loop Excision of the Transformation Zone, LLEC—Large Loop Excision of the Cervix, Loop Cone Biopsy of the Cervix)


    Loop electrosurgical excision procedure (LEEP) uses a thin wire loop to precisely cut out areas of the cervix. The cervix is a neck-like structure that connects the vagina and uterus. LEEP is done to remove abnormal cervical cells.

    Reasons for Procedure

    LEEP is often done after abnormal cells have been found on the cervix. These abnormal cells are often found on a Pap test . If the cells found on a Pap test show cervical dysplasia (abnormal cells) or cancer cells, a LEEP may be done.

    Possible Complications

    Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
    • Bleeding
    • Abdominal cramping
    • Infection
    • Future pregnancy problems (small increased risk of premature births and having a low birth weight baby)
    • Narrowing of the cervix (rare)
    • Incomplete removal of the abnormal tissue
    • Accidental cutting or burning of normal tissue
    Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
    • Smoking
    • Drinking
    • Chronic disease such as diabetes or obesity
    The following may also increase the risk of complications:
    • Menstruation at the time of the procedure—It is best to have LEEP done when you do not have your period.
    • History of pelvic inflammatory disease
    • Inflammation of the cervix
    • Pregnancy or possible pregnancy

    What to Expect

    Prior to Procedure

    Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
    The day of the procedure:
    • If your doctor will be giving you a sedative, arrange for someone to drive you home from the clinic.
    • If directed by your doctor, take a pain reliever before the LEEP.
    • Bring sanitary napkins to use after the procedure.


    Local anesthesia is often used for a LEEP. This will keep you from feeling pain during the procedure. You will be awake during the procedure. The anesthesia may be applied with a lotion or injected into the area.

    Description of the Procedure

    You will lie on your back on a table with your feet up in footrests. A speculum will be inserted into your vagina. This tool will separate the vaginal walls. This will allow the cervix to be viewed. Anesthesia will be applied to the cervix to numb the area.
    A solution will be applied to the cervical area. The solution will show the abnormal area that needs to be removed. A thin wire will be inserted into the vagina toward the cervix. You will hear a vacuum-like noise. You may also hear a humming noise. The thin wire loop is like a surgical knife. The abnormal tissue will be removed. You will need to stay still. The area will be cauterized. This process heats the blood vessels to stop bleeding. A paste may also be applied to stop bleeding.

    How Long Will It Take?

    LEEP only takes a few minutes.

    How Much Will It Hurt?

    You may feel cramping during LEEP. You should not feel any sharp pain.

    Post-procedure Care

    At the Care Center
    Your blood pressure and heart rate will be checked.
    During your stay, the care center staff will take steps to reduce your chance of infection such as:
    • Washing their hands
    • Wearing gloves or masks
    There are also steps you can take to reduce your chances of infection such as:
    • Washing your hands often and reminding visitors and healthcare providers to do the same
    • Reminding your healthcare providers to wear gloves or masks
    At Home
    After the procedure, you may have:
    • Dark brown-black vaginal discharge for several days
    • Mild cramping
    • Watery pink discharge
    When you return home, do the following to help ensure a smooth recovery:
    • Rest when you get home.
    • Frequently change the sanitary pad.
    • Take pain medication as directed.
    • It will take a few weeks for your cervix to heal. For 4 weeks:
      • Do not use tampons or douches.
      • Refrain from sexual intercourse.
      • Do not do any heavy lifting.
      • It is okay for you take baths and showers.
    • If advised by your doctor, have a Pap test and pelvic exam every 6 months.

    Call Your Doctor

    After arriving home, contact your doctor if any of the following occurs:
    • Heavy bleeding (more than your normal period)
    • Bleeding with clots
    • Severe abdominal pain
    • Fever or chills
    • Unusual odor or discharge
    If you think you have an emergency, call for medical help right away.


    American Congress of Obstetricians and Gynecologists http://www.acog.org

    Family Doctor—American Academy of Family Physicians http://familydoctor.org


    Canadian Women’s Health Network http://www.cwhn.ca

    Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org


    American Congress of Obstetricians and Gynecologists. Management of abnormal cervical cytology and histology. Practice Bulletin. 2010; 99.

    Emam M, Elnasar A, Shalen H, Barakat R. Evaluation of a sinfle-step diagnosis and treatment of premalignant cervical lesions by LEEP. Int J Gynaecol Obstet. 2009;107(3):224-7.

    Loop electrosurgical excision procedure (LEEP). American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/Patients/FAQs/Loop-Electrosurgical-Excision-Procedure-LEEP. Updated July 2014. Accessed October 7, 2015.

    Loop electrosurgical excision procedure (LEEP). American Society for Colposcopy and Cervical Pathology website. Available at: http://www.asccp.org/Education/COURSES-Comprehensive-Colposcopy-HRA-Advanced-and-more/Loop-Electrosurgical-Excision-Procedure-LEEP. Accessed October 7, 2015.

    Noehr B, Jensen A, Kjaer SK. Depth of cervical cone removal by loop electrosurgical excision procedure and subsequent risk of preterm delivery. Obstet Gynecol. 2009;114(6):1232-8.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.