Circumcision Techniques

Plastibell method:

It is a circumcision method used to circumcise babies. A plastic device known as Plastibell is used. The Plastibell is a small, plastic bell, with a rim on the open side The bell is designed to sit over the glans of the penis. The device comes in different sizes and the doctor will select which bell is the correct size for the baby being circumcised. 

The foreskin is retracted and a device known as haemostat is placed on each side of the foreskin. The Plastibell is placed over the glans and secured around the rim with a string. The handle of the Plastibell is then removed. The Plastibell will eventually fall away as the skin which is attached to it dies. 

Research shows that the older the boy is at the time of the circumcision, the longer the Plastibell takes to fall off. Minor complications also commonly arise following Plastibell circumcision with the most common one being the Plastibell getting wedged into the penis and failing to fall off.

Gomco clamp method:

This method of circumcision uses tools called the Gomco bell and clamp, to assist with the surgical procedure. The bell has a long handle, which is placed through a hole in the base plate of the clamp during the procedure. Gomco circumcision is the most popular method in countries like the US. Circumcisions performed using the Gomco clamp are typically quick and easy surgical procedures which result in less bleeding.

A slit is made in the foreskin on the upper side of the penis, and a Gomco bell of the correct size is placed over the glans and the foreskin is drawn over the ball. The bell is then inserted into a circular opening in the base plate of the Gomco clamp. The bell is drawn up into the clamp until the open end, surrounded by the foreskin, is fitted in the opening. The clamp is then tightened, crushing the skin between the clamp and bell and the foreskin is cut away using a scalpel. 

The clamp is then left in place for five minutes to allow blood to coagulate. Antiseptic is later applied to the wound if any bleeding occurs the wound is cleaned and stitches are generally not necessary. 

Morgen Clamp Technique

A shield and a clamp are used in this method. The foreskin is separated from the head of the penis with a probe. It is then pulled out in front of the head and inserted through a metal clamp with a slot in it. The clamp is held in place while the foreskin is cut with a scalpel. No stitching is done and the bleeding is controlled. The wound is simply bandaged to achieve haemostasis. Injury to the glans is uncommon but however, bleeding is a major concern in this method.

Dorsal slit

The dorsal slit method is common and is used when the glans is inflamed due to infection or balanitis. The dorsal slit is recommended when circumcision is indicated for phimosis or paraphimosis. The procedure is carried out as the normal conventional circumcision without any use of special equipment.