INTRODUCTION1. One of the procedures of conization surgical procedure. 2. It is one of the approaches to treat high grade cervical

dysplasia.3. Done to treat a Pap smear that is abnormal. 4. Used to remove any tissue of Pap smear indicates the

presence of abnormal cervical cells. (Daniel, n.d.), (Cornforth, 2009)

PURPOSE1. To treat abnormal cervical tissues and dysplasia.2. To detect and to assist in diagnosis and treatment of: • Polyps • Genital wart

Figure 1: Polyps Figure 2: Genital wart •Diethylstilbestrol (DES) – a synthetic form of estrogen.

(Chen W. and Guan T., 2010)

CONIZATION SURGICAL PROCEDUREPre-test Patient Preparation1. Explain the purpose & procedure2. Explain complications3. Tell possible diagnosis 4. Notify your physician - allergic, medications taking,

bleeding5. Sign a consent form

(Fischbach F., 2004)

Equipments

Forcep Speculum

Monsel’s solution Electrosurgical dispersive pad

Figure 3: LEEP equipments(Anonymous, n.d.)

Method: Loop Electrosurgical Excisions Procedure

Table 1 (Anonymous, n.d.)

1. Patient undresses from the waist down and put on a hospital gown.

2. Patient need to empty the bladder.

3. Thepatient wasplaced in alithotomyposition.

4. Speculum connected to smoke- evacuator tubing, was inserted into the vagina.

5. A vinegar/lugol’s solution is applied on the cervix.

6. Physician places a colposcope near the opening of the vagina.

7. The cervix is then numbed with local anesthesia.

8. An electrically charged loop is inserted up to the cervix.

9. Loop passedacross thecervix, cutsaway andremoves theabnormal cells.

10. Monsel’s solution is applied to the area.

11. The tissue that is removed will be studied in a lab to confirm the diagnosis.

Post-test Patient Preparation1. Rest for few minutes.2. Wear sanitary pad.

3. Avoid from douche or having intercourse for 4 weeks.4. Avoid from strenuous activities.5. Inform physician when having bleeding with clot, foul-

smelling drainage, fever or chill and/or severe abdominal pain.

(Chen W. and Guan T., 2009)

Table 2

CONCLUSION1. Leep procedure replaces the traditional biopsy.2. It used when pre-cancerous cell on the surface of cervix

have. (Dunn T.S., 2007)

CONIZATION SURGICAL PROCEDURE: LEEPNUR HAFIZAH I., NORISMA AZIDA I., WAN NOORASNI M. N., MELLISA ROZELINI R., MUHAMAD FIRDAUS Z., ZAHID Z., MOHAMAD NAIM S.@S.

BACHELOR OF MEDICAL LAB. TECHNOLOGY (HONS), FACULTY OF HEALTH SCIENCE, UNIVERSITI TEKNOLOGI MARA, PUNCAK ALAM CAMPUS, 42300 BANDAR PUNCAK ALAM, SELANGOR

ADVANTAGES DISADVANTAGES1. Provides an adequate

specimen for pathological study.

2. Very quick & minimal painful procedure.

3. Performed under local anesthesia.

4. Does not appear to affect fertility.

5. Prevent the human and financial cost.

(Mayeaux E. J., n.d), (Gardasil, 2010)

1. Bleeding, discharge, and possible infection.

2. Narrowing of the cervix.3. Accidental cutting or

burning of normal tissue.4. Pelvic infection can

occur.5. Risk in the future

pregnancies.(Kitchen, 2009)

REFERENCESAnonymous, (n. d.). Loop Electrosurgical Excision Procedure (LEEP). Retrieved from http://www.sharp.com/healthinfo/content.cfm?pageid=P07780Chen W. and Guan T., (2010). Loop Electrosurgical Excision Procedure (LEEP). McKinley Health Center, University of Illinois.Dunn T. S. et al, (n.d). Diagnosis and treatment of grade III cervical intraepithelial neoplasia by cervical conization in 98 patients.Fischbach F., (2004). A Manual of Laboratory and Diagnostic Tests, Edition 7, p. 840-841.Genit J. L., (2007). Absent endocervical cells on Pap smears after loop electrosurgical excision procedure. Johnsan C., (2009). Leep Surgery Side Effects. Retrieved from www.ehow.com/about_5368741@leep-surgery-side-effects.htmlKidong K. et al.(2009). Value of Second Pass in Loop Electrosurgical Excisional Procedure. Kitchen R. E. C., (2009). Leep Surgery Complications. Retrieved from http://www.ehow.com/about_5341343_leep-surgery-complications.htmlMayeaux E. J., (n.d). Advantages of LEEP. Retrieved from http://lib-sh.lsuhsc.edu/fammed/atlases/leep/leepadv.html

Figure 13: Normal

histological

Superficial cell

Intermediate

Parabasal

Figure 12: CIN 3 histological

No surface maturation

Mitotic figure are sparse

Figure 4: Lithotomy position Figure 5:

Insertion of speculum

Figure 6 : Vinegar Figure 7: Lugol’s Figure 8: Colposcopy observation

Figure 9: Insertion of loop

Figure 10: Removing

Figure 11: Monsel’s solution

H&Ex40 H&Ex40

Figure 14: Equipments used after LEEP