There are two main types of circumcision: guillotine and stout locking forceps. A stout lock forceps clamps across preuce paralleling the corona and glans. A scalpel is used flush to the forceps to remove the preuce. Both methods protect your glans. These techniques may be used before or after circumcision.

Procedure

A dorsal slit is used in most circumcision methods. This is a common procedure. In cases of acute inflammation, it may be done alone. The slit prevents phimosis or paraphimosis, and increases the circumcision ring. The technique used may allow for the removal of the prepuce before or after circumcision. Here are the steps involved in this technique.

First, the doctor cleans baby’s penis. The doctor then uses special clamps to remove excess foreskin. A small amount is applied to the area to protect it against diaper rubbing. The whole procedure takes about 40 minutes. While the procedure isn’t painful, the whole process can be emotionally hard for parents.

Complications

Although complications of circumcision technique are rare, they may occur. Some complications result from improper use of an electric cutter or infection. Another is a poor placement of the Mogen clamp, which is designed to allow the foreskin to enter the compression area while preventing the glans. Amputation can occur if the glans get trapped in the Mogen Clamp. In such cases, a pediatric surgeon may perform a glans reconnectment.

Infection is a rare side effect of circumcision. Many physicians mistake a yellowish scab as an infection, but these are simply part of the healing process. Plastibell devices, which can harbour foreign bodies, are prone to infection. It is imperative to get the infection under control quickly. However, infections in newborns can be serious. There have been reports of meningitis, gangrene and necrotizing fascitis.

Methods

There are two main methods of circumcision, surgical and nonsurgical. The first, surgical, involves a cut to remove the skin. Surgery, on the contrary, does not require a cut. Instead, it requires the surgeon to remove most, or all, of the foreskin. Both of these procedures are performed under local anesthesia. The procedure is painless and quick under local anaesthesia.

The second method is the Forceps Guided method. This technique is similar to the Shield and Knife method, but uses forceps as a guide. The foreskin is pulled out over the penile shaft. Stout locking forceps are then clamped across the foreskin, parallel to the glans. The surgeon then cuts across the forceps to protect the glans. This method is sometimes used by patients with paraphimosis, phimosis, or other forms of paralysis.

Scars

The technique used to circumcise the body will affect the scarring. Open surgical techniques using sutures can result in uneven scarring, while newborn circumcisions often produce a fine, even scar with minimal adhesions or skin bridges. A concealable circumferential scar may be possible with nonsurgical foreskin repair. Parents should be aware, however, that it could take several months for the scar to return to its original color.

Doctors may use stitches to reattach skin to the shaft during the procedure. The skin can become loose or fall off. Scars that are left over after circumcision may develop keloids, tumor-like tissue. These growths can be large enough for additional surgery. Before surgery, patients should discuss the possibility of developing Keloids with their surgeon. They will typically be a different color than the surrounding skin, but they will fade with time.

Precautions

Before performing circumcision, it is important to assess the amount of penile shaft skin. To determine how much skin lies below the base plate, a coronal Ridge can be marked. The bevel hole must be pulled through with equal amounts of mucous membrane and skin. Failure to separate mucous membrane from glans could lead to adhesions and/or phimosis.

To relieve pressure during circumcision, a small cut is made to the foreskin. A slit should be made through the foreskin in order to allow penis and skin to be separated without too much pressure. In the event of excessive bleeding, the healthcare professional can apply pressure to or push the penis forwards. This technique may not be suitable for all patients.