The loop electrosurgical excision procedure (LEEP) is one of the most commonly used approaches to treat high grade cervical dysplasia (CIN II/III, HGSIL) and early stage cervical cancer discovered on colposcopic examination. In the UK, it is known as large loop excision of the transformation zone (LLETZ). It is considered a type of conization.[1] It has been in use since the 1970s, after its invention by Dr. Sheldon Weinstein. [2]
LEEP has many advantages including low cost and a high success rate.[3] 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.[4] Disadvantages include reports of decreased sexual satisfaction [5] 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.[6] Approximately 500,000 LEEP procedures are performed in the U.S. annually. [7]