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986 Three modifications to facilitate the use of LEEP in low resources settings
  1. Rafik Ibrahim Barakat and
  2. Reda Hemida Elshouky
  1. Mansoura Faculty of Medicine, Mansoura, Egypt


Introduction/Background LEEP is considered a standard treatment for cases with CIN specially high grades (2,3). Its use is effective and achievable, but in low resources situations it may face difficulties. Cost is a main limitation factor that reduce its generalisation in public hospitals.

Another challenge is the use in large volume cervix that may bleed intraoperative or be complicated with 2ry hemorrhage.

Methodology We introduced 3 modifications to the standard LEEP, including instruments and methodology:

  1. Use the spinal needle or stylet on the top of diathermy pen as a loop for cutting and coagulating the target cervical tissue.

  2. Making two cervical stitches at 3 and 9 o’clock to ensure hemostasis specially in large volume cervix.

  3. Traction on the cervical angle ligatures to improve exposure and fasten the procedure.

Results We found that the application of the three modifications has improved the aimed outcomes:

  1. Reducing instrumental cost per case from a range 50–60 $ to only about 4–5 $ (according to different cases)

  2. Intraoperative bleeding was reduced significantly specially in large volumes cervix.

  3. Better exposure and less procedure time.

Conclusion The use of Mansoura-3 modifications for LEEP appears to help its generalisation of its use in low resource settings.

Disclosures Nothing to disclose.

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