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Paediatric sutureless circumcision and modified circumcision: video demonstration
Neil C Featherstone1, Feilim L Murphy
1Department of Paediatric Surgery & Urology, St George's Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK. neilfeatherstone@doctors.org.uk
Insights
Tissue glue offers a sutureless alternative for pediatric circumcisions, yielding excellent cosmetic results and reduced pain. This technique is easily teachable and a viable option compared to traditional sutured methods.
Area of Science:
- Pediatric Surgery
- Urology
Background:
- Circumcision employs diverse surgical techniques.
- Modified circumcision for specific conditions requires optimal cosmetic outcomes.
- Tissue glue presents a sutureless alternative for pediatric circumcision, offering benefits in cosmesis and pain management.
Purpose of the Study:
- To demonstrate a sutureless circumcision technique using tissue glue.
- To present a modified circumcision technique for hooded prepuce or mild glanular hypospadias.
- To highlight the cosmetic and pain advantages of tissue glue in pediatric circumcision.
Main Methods:
- Preputial skin incisions marked and executed with a scalpel.
- Ensured complete hemostasis before applying tissue adhesive via a 32-gauge needle for controlled application.
- Carefully avoided applying glue to the coronal sulcus, followed by cleaning and temporary dressing.
Main Results:
- Successfully performed 57 circumcisions and 30 modified circumcisions between November 2008 and September 2011.
- No complications were reported in any of the cases.
- All patients were followed up for a minimum of 3-6 months post-procedure.
Conclusions:
- The sutureless tissue glue technique achieves consistently excellent cosmetic results.
- This method is readily teachable to junior surgical staff.
- It represents a valuable alternative to standard sutured circumcision procedures.
Objective:
Circumcision is undertaken using a variety of surgical methods. Modified circumcision for the hooded prepuce or mild glanular hypospadias mandates an excellent cosmetic result. Tissue glue is an alternative to sutures for circumcision in children and has significant advantages in terms of cosmesis and postoperative pain. We present two detailed videos demonstrating our technique for sutureless circumcision and modified circumcision.
Method:
The incisions were marked on the outer and inner preputial skin. Incisions were made with a scalpel. Complete haemostasis was ensured. Tissue adhesive was placed onto the wound using a 32-gauge needle to allow controlled application. It is important to ensure that the coronal sulcus is free of glue at the end of the procedure. Once the circumcision is complete the penis can be cleaned and temporarily dressed.
Results:
Between November 2008 and September 2011, we have used this technique for 57 circumcisions and 30 modified circumcisions. No complications occurred. All were followed up for a minimum of 3-6 months.
Conclusion:
The technique allows reproducible excellent cosmetic results, can be easily taught to junior surgical staff and should be considered as an alternative to a standard sutured circumcision.

