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:
- to remove an area of abnormal cells from the cervix after cervical screening
- to help diagnose cervical cancer
- to treat cervical cancer.
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.
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.
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.
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.
Below is a sample of the sources used in our cervical cancer, cervical screening and CIN information. If you would like more information about the sources we use, please contact us at email@example.com
GOV.UK. Cervical screening: programme overview. Updated 18 November 2019. Available from www.gov.uk/guidance/cervical-screening-programme-overview (accessed March 2020).
GOV.UK. Colposcopic diagnosis, treatment and follow up. Updated 5 February 2020. Available from www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management/3-colposcopic-diagnosis-treatment-and-follow-up (accessed April 2020).
Marth C, Landoni F, Mahner S, et al. Cervical cancer: ESMO clinical practice guidelines. Annals of Oncology, 2017; 28, suppl 4, iv72–iv83. Available from www.esmo.org/guidelines/gynaecological-cancers/cervical-cancer (accessed October 2020).
Reed N, Balega J, Barwick T, et al. British Gynaecological Cancer Society (BGCS) cervical cancer guidelines: recommendations for practice. 2020. Available from www.bgcs.org.uk/wp-content/uploads/2020/05/FINAL-Cx-Ca-Version-for-submission.pdf (accessed October 2020).
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.
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