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LLETZ

Large loop excision of the transformation zone for CIN2+ / high-grade changes.

Source: NHS Cervical Screening Programme

Steps

  1. Colposcope; insulated speculum with smoke extraction.
  2. Acetic acid ± Lugol’s iodine to outline the transformation zone.
  3. Local anaesthetic with vasoconstrictor into cervix.
  4. Choose loop to fit; single pass — ~7–10 mm deep for type 1 TZ (deeper for type 3).
  5. Ball diathermy to base; Monsel’s if needed.
  6. No tampons or sex for 4 weeks; test of cure HPV test at 6 months.
Deeper excisions raise preterm birth risk — excise only what is needed.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.