In collaboration with a medical devices company in Utah, the engineering performance of the Liger Thermal Coagulator will be developed and tested in vitro and in vivo. 200+ Liger units will be produced and a randomised controlled trial of the device will be undertaken, compared to cryocautery and LLETZ using efficacy and user friendliness as endpoints. The inclusion of a study arm of excisional therapy will allow to quantify the rate of overtreatment in VIA programmes and using the Z scan may allow for a non invasive method of accurately predicting normality and abnormality in VIA positive women.