Large-Loop Excision Using a New Probe: Variloop for the Treatment of CIN

Our objective was to evaluate the efficiency of using a diathermic loop with an adjustable diameter (Variloop for the treatment of cervical intraepithelial neoplasia (CIN) in outpatient surgery.

Loop electrosurgical excision was performed on 185 patients, including 21 (11.3%) with low-grade lesions and an endocervical squamocolumnar junction, 44 (23.7%) with CIN2, 118 (63.7%) with CIN3, and 2 (1%) with discrepancies between cytological and histological findings. The procedure was performed in an average of 10 minutes. For 177 patients, local anesthetic was used. In all cases, the specimen was removed in one piece.

We observed minimal epithelial distortion with mild coagulation necrosis at the edge of the specimens in 2 of 185 (1%) cases, but this did not interfere with the histological evaluation. Correlation between the biopsy and the conization diagnosis was the best for CIN3, found in 70% of the cases. However, two cases of microinvasion and three cases of adenocarcinoma in situ that were diagnosed were not suspected preoperatively in any of these patients. In 171 of 185 cases (92.4%), there was no endocervical margin involvement. At the 1-year follow-up, two patients had a moderate stenosis with a squamocolumnar junction not visualized, and two others had a severe stenosis with a marked cervical narrowing.

The use of the diathermic loop with adjustable diameter (Variloop) allows efficient treatment of CIN, wherein endocervical development does not exceed 15 mm from the external os without causing significant thermic alterations.