Treatment by LLETZ – Instruments and consumables
- Examination table
- Examination gloves
- Insulated self-retaining speculum with a smoke extraction channel
- Lateral vaginal speculum (rarely necessary)
- Sponge-holding forceps
- Cotton-tipped swabs
- Freshly prepared 5% acetic acid
- Lugol’s iodine
- Focusing light for examination
- Suction machine
- Electrosurgical unit (ESU)
- Loop/ball electrodes
- Hand-operated switch for the ESU
- Monsel’s solution/paste
- Local anaesthetic (lignocaine or prilocaine) injection
- Dental syringe (preferred) or 10 cc syringe and needles
- Vials containing 10% formaldehyde for collecting tissue for biopsy
- Gauze pieces
- Sutures to control bleeding
Preparation of dental syringe and needle
- The smoke generated must be sucked out either by a smoke evacuator (preferred) or by a suction machine attached to the smoke extraction channel.
- An insulated speculum is preferred but not essential. Regularly check the insulated speculum for any damage to the insulation coating.
- An insulated lateral vaginal retractor may be used if the lateral vaginal walls are patulous and obstruct the view. However, it causes discomfort to the patient. A non-lubricated condom (with its end cut off) stretched around the speculum can also hold back the vaginal walls away.
- In most cases the procedure can be performed under local anaesthesia. Regional or general anaesthesia is required if:
- the lesion is large and/or extends to the vagina
- exposure is difficult
- the woman is uncooperative.
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