Loop electrosurgical excision procedure with an intrauterine device in place

Area of Science:

• Gynecology
• Surgical Procedures

Background:

• Traditionally, intrauterine devices (IUDs) are removed before loop electrosurgical excision procedures (LEEP) for cervical dysplasia.
• Existing alternatives risk suboptimal sampling or damage to IUD strings.

Purpose of the Study:

• To present a novel, safe, and effective method for performing LEEP without IUD removal.
• To establish a technique that preserves IUD string integrity and allows for optimal cervical sampling.

Main Methods:

• A protective hollow tube is placed over the IUD strings after securing them with a non-tensioned suture.
• The LEEP is then performed, with the tube shielding the IUD strings from the electrosurgical instruments.
• Hemostasis is achieved, the tube is removed, and the suture is trimmed to maintain original string length.

Main Results:

• The described procedure allows for successful LEEP performance without IUD removal.
• The technique effectively protects IUD strings from damage during the procedure.
• This method is applicable to both copper and levonorgestrel-releasing IUDs.

Conclusions:

• A new, effective technique for performing LEEP in IUD users without device removal has been developed.
• This procedure offers a safe alternative to traditional IUD removal, ensuring optimal cervical sampling and IUD preservation.
• Further adoption of this technique can improve patient care and procedural outcomes for women undergoing LEEP with IUDs.