How do they do the leep procedure in the office?

Easily. Loop electrical excision procedure (leep) is easily done in the office with a local block (i use 1% Lidocaine with epinephrine) and most patients note less pain than their colposcopies. I do have colleagues who do them in the or but it really does not require general anesthesia or sedation. I've done them over 17 years in the office without problems and they take approximately 10 minutes to do.