January 15, 2017 Liza Colimon, MD A Cold Knife Conization procedure is indicated once moderate to severe high grade dysplasia (abnormal cells) are confirmed after colposcopic examination and biopsies. It is particularly indicated if the cells were mostly found high in the endocervical canal, if there is a question of microinvasive abnormal cells, or If abnormal glandular cells were found. Often times, this procedure can be done in the office and is called a LEEP/Cone Procedure. Some surgeons prefer to use a scalpel for precision and better interpretation of the final pathology results and therefore will perform the procedure in the operating room. The procedure is both diagnostic (helps to ensure abnormal cells diagnosed are not more worrisome than reported after colposcopic biopsies) and therapeutic (removes the abnormal cells preventing further growth). A scalpel is used to remove the area on the cervix where the abnormal cells were identified and the tissue surrounding the endocervical canal. The procedure takes approximately 20 minutes. The procedure is performed in the operating room. You will go home the same day. You should abstain from placing anything in the vagina or intercourse for at least three days prior to the procedure and for up to four weeks after the procedure. If you start your period prior to the procedure, it should be rescheduled.