Chapter 248 Cervical Conization (Loop Electrosurgical Excision Procedure and Large Loop Excision of the Transformation Zone Conizations)
DESCRIPTION
Cervical conization is a diagnostic or therapeutic procedure that removes a cone-shaped specimen from the uterine cervix. Loop electrocautery excisional procedure (LEEP, also known as large loop excision of the transformation zone [LLETZ]) uses electric current instead of a knife to remove the cervical tissue.
INDICATIONS
Histologically verified advanced epithelial atypia (for diagnosis or therapy) or inability to adequately evaluate the cervix through colposcopy.
REQUIRED EQUIPMENT
• Skin (vaginal) preparation materials (iodine-based antibacterial solution [e.g., Betadine] or other suitable cervical cleansing agents)
• Electrosurgical generator with output capability of at least 50 watts in both coagulation and cutting modes, a variety of waveform outputs (pure cut, blended current, and coagulation current), patient grounding pad monitor, and isolated circuitry.
• A variety of loop electrodes (size and shape to be determined at the time of the procedure based on the size and shape of the cervix and lesion to be removed)
• Syringe with 25- or 27-gauge 1.5-inch needle for anesthetic injection, 1% or 2% lidocaine with or without 1 : 100,000 epinephrine

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