When is the best time for Lip Knife surgery

LEEP knife surgery, also known as LEEP knife technique, is a relatively advanced method for treating cervical diseases. We all know that gynecological diseases of the cervix can cause great harm to women's bodies and may even lead to infertility. It is very important to take appropriate treatment methods in a timely manner, but many patients are concerned about the best time for Lipknife surgery. So, when is the best time to have a Lipknife surgery? Let’s take a closer look below.

The best time for Lipknife surgery needs to be determined based on the condition of the patient.

The LEEP knife uses a high-frequency radio knife to pass the LOOP metal wire to generate 3.8 MHz ultra-high frequency (microwave) waves from the electrode tip. The moment it contacts body tissue, the tissue itself generates impedance, absorbs the radio waves to generate high heat, and forms steam waves with the water in the cells to accomplish various cutting, hemostasis and other surgical purposes, but does not affect the pathological examination of the tissue at the edge of the incision. The principles of high-frequency radiofrequency surgery are different from those of traditional electrosurgical surgery: traditional electrosurgical surgery uses the impedance of the electrode itself, and the high heat generated by the current passing through it to achieve the surgical purpose. The output frequency is 0.3-1.0 MHz, while the heat energy converted by the radio frequency of the high-frequency radiofrequency surgery is generated inside the tissue. The sine wave generated by the radio frequency causes the water in the cells to oscillate, generating heat and evaporation. The cells contacted by the emission technique rupture, causing the tissue to separate, and the radio frequency emitter itself does not generate heat.

Technical Process

Overview

LEEP technology can be used to treat cervical intraepithelial neoplasia (CIN) and vaginal epithelial malignancy (VIN). It can continuously remove the high-risk area for cervical cancer (the junction of the cervical squamous-columnar epithelium), effectively preventing cervical cancer. It is a safe and effective surgery that does not require hospitalization and has few complications. It can also retain complete and continuous specimens for pathological examination, significantly reducing the misdiagnosis and missed diagnosis rates of cervical cancer.

Indications for surgery

The literature suggests that the surgical indications for LEEP include: (1) suspected CIN2, CIN3 under cytology and colposcopy; (2) suspected early invasive cervical cancer or carcinoma in situ; (3) persistent CIN1 or inconvenient follow-up of CIN1 patients; (4) suspected cervical ASCUS or symptomatic cervical ectropion. The problem with LEEP treatment is that too much tissue is removed. To be cautious, cone biopsy is usually performed for ≥ CIN2, and biopsy is performed for ASCUS and CIN1. The indications for traditional electrosurgical surgery only include conditions (1) and (2) mentioned above.

Scope of surgery

Regarding the scope of LEEP surgery, according to literature reports, lesions ≥ 2.5 cm should be cone-cut, and the scope of cone-cut should exceed normal tissue by 1 mm. Based on the experience of carbon dioxide laser treatment of CIN, it was found that the depth affects the cure rate. The average depth of CIN involving cervical glands is 1.24 mm, and the deepest is 5.22 mm. As the depth of laser treatment increased from 3 mm to 5 mm, the cure rate of lesions also increased from 68% to 87%. Studies have shown that the ideal depth for LEEP cone biopsy of the cervix is ​​about 7 mm. According to literature reports, a needle electrode is repeatedly inserted into the cervical canal to a depth of 1.5 cm to destroy lesions in the cervical canal. This improvement has increased the cure rate and reduced the persistence rate of lesions to 2.7%. This study suggests that the ideal depth of LEEP cone biopsy of the cervix should be about 15 mm. The results suggest that LEEP conization in this range is more time-saving, labor-saving and safer than traditional electrosurgical conization. Regarding LEEP biopsy, research results have confirmed that a cervical depth of 4 mm and a cervical canal depth of 4 mm can achieve both diagnostic and therapeutic effects while avoiding the removal of excessive tissue, which is superior to cervical forceps biopsy.

I think everyone should be clear about the best time for Lip knife surgery. The best time for Lip Knife surgery is not always fixed. It is mainly determined by the patient's condition. Each patient has a different physical condition, and the best time for surgery is different. This is mainly judged by the doctor based on the patient's condition. I hope patients can understand this.