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)
by Deanna M. Neff, MPH
Loop electrosurgical excision procedure (LEEP) uses a thin wire loop to cut out areas of the cervix. The cervix is the lowest part of the uterus. The Loop allows precise cuts.
Reasons for Procedure
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems, like:
The doctor will talk about ways to manage risks. Factors that can increase your risk of problems include:
The following may also increase the risk of complications:
What to Expect
Prior to Procedure
Talk to your doctor about your medicine that you take. You may be asked to stop taking some medicine up to 1 week before the procedure.
The day of the procedure:
Local anesthesia is often used for a LEEP. It will numb the area, but you will be awake. The anesthesia may be applied as 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 area. It will highlight abnormal cells. A thin wire will be inserted into the vagina toward the cervix. The abnormal tissue will be removed with the thin wire. The tool heats the area to stop bleeding from blood vessels. 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.
At the Care Center
You will be allowed to rest. When you are ready, you can go home.
It will take a few weeks for the area to fully heal. Most can return to normal activity in a few days.
Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:
If you think you have an emergency, call for emergency medical services right away.
The American Congress of Obstetricians and Gynecologists
Family Doctor—American Academy of Family Physicians
Canadian Women’s Health Network
The Society of Obstetricians and Gynaecologists of Canada
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 single-step diagnosis and treatment of premalignant cervical lesions by LEEP. Int J Gynaecol Obstet. 2009;107(3):224-7.
Loop electrosurgical excision procedure (LEEP). The American College of Obstetricians and Gynecologists website. Available at:
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Updated July 2017. Accessed March 19, 2020.
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.
Last reviewed September 2019 by EBSCO Medical Review Board Mary-Beth Seymour, RN
Last Updated: 9/18/2020
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