Large loop excision of the transformation zone (LLETZ)

Large loop excision of transformation zone (LLETZ) is a common way to remove abnormal cells from the cervix.

What is LLETZ?

Large loop excision of transformation zone (LLETZ) is a common way to remove abnormal cells from the cervix. It is sometimes called loop electrosurgical excision procedure (LEEP).

You may have this:

You may find this type of treatment upsetting or embarrassing. Your healthcare team will try to help. Let them know how you are feeling and tell them if you have any questions or worries. If you want to bring someone with you for support during the treatment, this can usually be arranged.

What is NETZ?

Needle excision of the transformation zone (NETZ) is similar to a LLETZ. The main difference is that the thin wire used to cut away the affected area is straight, instead of in a loop.

Having LLETZ

LLETZ usually takes about 5 to 10 minutes and is usually done under a local anaesthetic as an outpatient.

When you are ready, you undress from the waist down. You then lie on your back on an examination couch. Some clinics have couches with foot or leg supports that you can rest your legs up on. You will be asked to lie with your knees bent and apart.

MACD234_Colposcopy-procedure_unlabelled_20170918_tcm9-328275
Image: Getting ready for LLETZ

The doctor or nurse gently puts an instrument called a speculum into the vagina. This holds the vagina open so that they can see the cervix. It should not hurt but sometimes it can feel uncomfortable.

Image: How LLETZ is done

Some local anaesthetic is used to numb the cervix. Then, the doctor or nurse removes the abnormal area using a thin, loop-shaped tool. The loop is heated with an electric current. It cuts and seals the tissue at the same time. This should not be painful, but you may feel some pressure inside the cervix.

If a larger area of the cervix is removed, you may need a general anaesthetic and may stay in hospital for the day or overnight.

About our information

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected. Our aims are for our information to be as clear and relevant as possible for everyone.

You can read more about how we produce our information here.