LLETZ (Large Loop Excision of Transformation Zone of the Cervix) Procedure

You have been advised for surgical treatment of abnormal cells on your cervix. This procedure is known by several names, including “LLETZ” (Large Loop Excision of Transformation Zone of the Cervix) or “LEEP” (Loop Electrosurgical Excision Procedure) or just as “loop procedure of the cervix”.

Procedure

This is a minor day-procedure done in the hospital under a short general anaesthesia. The procedure will take around 10-20 minutes. You will go home the same day. 

While under anaesthesia, a colposcopy will be done again to highlight the affect area on the surface cervix. Then electrosurgical current will be passed into an instrument with a wire loop at the end to remove the areas with abnormal cells.

The aim will be to remove the abnormal cells without removing too much normal cervix. Usually in pre-menopausal women this would be around 1cm thickness or less.

Risks

Risks of the procedure discussed with you at the time of consenting includes anaesthesia, injection, bleeding and re-operation for recurrence of abnormal cells. There can also be an increase in complications in future pregnancies such as premature labour or miscarriages, or cervical stenosis that may necessitate a caesarean section if the cervix does not dilate in labour. The overall chances of these complications in pregnancy are low, but it is higher compared with women who have not had cervical procedures.

Post operation

You will go home on the same day. Post-operative discomfort is usually a lower abdominal cramping like period pain, not dissimilar to the cramps after your colposcopy.

After your procedure you will also likely experience discharge, lasting for up to 2-3 weeks after the procedure. This discharge can vary in colour and consistency. Some women describe the discharge a few days after the procedure as looking like “chicken skin”. Please be reassured that this is an after effect of the medication applied during the operation for infection and bleeding control.

Intercourse, spas or swimming pools, baths and other strenuous activities should be avoided until 1 week after the discharge settles, to minimise the chance of infection.