The loop electrosurgical excision procedure (LEEP) is one of the most commonly used approaches to treat high grade cervical dysplasia (CIN II/III, HGSIL) and early stage cervical cancer discovered on colposcopic examination. In the UK, it is known as large loop excision of the transformation zone (LLETZ). It is considered a type of conization. It has been in use since the 1970s, after its invention by Dr. Sheldon Weinstein.
LEEP has many advantages including low cost and a high success rate. The procedure can be done in an office setting and usually only requires a local anesthetic, though sometimes IV sedation or a general anesthetic is used. Disadvantages include reports of decreased sexual satisfaction and potential for preterm labor, though a meta-analysis published in 2014 suggested that in patients with existing CIN lesions as opposed to controls, the risk is not more than their baseline risk. Approximately 500,000 LEEP procedures are performed in the U.S. annually.