A technique for cone biopsy using loop diathermy is presented. The diathermy loop consists of an insulated shaft attached to an insulated transverse or U-shaped arm, to which the loop wire is attached. The diathermy power is supplied by an electrosurgical unit. Among the first 50 cases, the mean age was 41.6 years; 72% of the cases were reported as cervical intraepithelial neoplasia III and 6% as microinvasive carcinoma. The mean length of the cone was 20.2 mm and the mean weight 3.9 g. Only 10% of the cones were reported as incompletely excised. No major complications were observed, and minor complications were reported in four patients (8%). We found this technique to be quick, simple, and economical. It provides a good histologic specimen with a low incidence of short-term morbidity.
The colposcopic and cytological findings at follow-up of 1000 women treated by laser ablation for cervical intraepithelial neoplasia or human papillomavirus infection at the Regional Department of Gynaecological Oncology, Gateshead, were reviewed. Colposcopy detected six of 27 patients with residual disease compared with cytology which was abnormal in 26 of the 27 and detected 21 as abnormal on the first visit after laser treatment. In our unit invasive disease after laser treatment was never detected solely on initial colposcopic review.