In conization, or cone biopsy, the doctor collects a cone-shaped tissue sample from the cervix, explains WebMD. In the loop electrosurgical excision procedure, or LEEP, the doctor uses a loop-shaped hot wire to collect abnormal tissue, according to UW Medicine. The procedure takes about 15 minutes.
During LEEP, the doctor inserts an instrument called a tenaculum into the vagina to keep the cervix steady, states Johns Hopkins Medicine. She then uses an electrified wire loop, which is usually hot enough to cauterize blood vessels and staunch any bleeding. Medication may also be applied to stop bleeding, notes UW Medicine. The size of the biopsy material is usually about 1.5 centimeters wide and 1 centimeter deep.
LEEP is an outpatient procedure performed in the doctor's office, explains UW Medicine and Johns Hopkins Medicine. The woman rests and is observed for a few hours before she goes home. Conization is also an outpatient procedure but is different from LEEP in that it is performed in a hospital operating room, says UW Medicine. The procedure is recommended if cancer is strongly suspected because it does not leave burns that hide the extent of the malignancy. The woman is given general or local anesthesia. The doctor can also use LEEP; a carbon dioxide, or CO2 laser; or a scalpel to remove the cone.