Electroconization of the cervix with a fine-needle electrode.

OBJECTIVE: To obtain electroexcised specimens in which the endocervical margin of the lesional tissue is devoid of thermocoagulation injury, facilitating accurate histologic interpretation of early stromal invasion.
METHODS: Using local anesthesia, we performed electroexcision with fine-needle electrodes and a tonsillar snare wire; no sutures to the lateral vessels were required. We tried to obtain cylindrical specimens. The procedure was performed in 38 women with deep canal involvement by squamous intraepithelial lesions, without colposcopically visible endocervical margins.
RESULTS: The mean duration of the procedure was 12 minutes (range 8-26). Complications occurred in seven of 38 patients (18%): four cases of perioperative bleeding, one of delayed bleeding, and two of asymptomatic stenosis of the external os. All cases were managed on an outpatient basis. Two cases of unsuspected microinvasive carcinoma were discovered.
CONCLUSION: In nonpregnant women in whom the endocervical limit of a lesion cannot be visualized with a colposcope, fine-needle electroconization is an attractive alternative to loop electroexcision. With this technique, cervical specimens can be collected without thermal damage to the endocervical margins.