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[Clinical observation of pre-suture ligation and suture knot positioning in single-operator circumcision with the
Bo Li1, Guo-Sheng Xu1, Zheng-Xing Zhou1
1Department of Urology, The Third Affiliated Hospital of Anhui Medical University / Hefei First People's Hospital, Hefei, Anhui 230001, China.
Insights
Pre-suture ligation with stapler circumcision significantly improves outcomes by reducing operation time, blood loss, and complications. This technique enhances patient satisfaction and minimizes anxiety for parents and surgeons.
Area of Science:
- Urology
- Pediatric Surgery
- Surgical Techniques
Context:
- Circumcision is a common surgical procedure in pediatric patients.
- Phimosis and redundant prepuce are common indications for circumcision.
- Stapler-assisted circumcision is a widely used technique.
Purpose:
- To evaluate the clinical efficacy of pre-suture ligation and suture knot positioning in single-operator circumcision using a stapler.
- To compare the outcomes of traditional stapler circumcision with modified techniques.
Summary:
- A study involving 120 children compared three circumcision methods: traditional stapler, stapler with double suture knots, and stapler with pre-suture ligation and suture knot positioning.
- The pre-suture ligation group demonstrated significantly reduced operation time, intraoperative blood loss, hematoma incidence, residual suture knots, and perioperative anxiety.
- This group also reported higher patient satisfaction with foreskin reservation, frenulum appearance, and incision aesthetics compared to the other groups.
Impact:
- The findings suggest that pre-suture ligation combined with suture knot positioning offers a superior approach to stapler-assisted circumcision.
- This technique can lead to improved surgical efficiency and patient outcomes.
- It also contributes to enhanced patient and parent satisfaction, potentially reducing overall healthcare burden.
Objective:
To observe the clinical effects of pre-suture ligation and suture knot positioning in single-operator circumcision with the stapler.
Methods:
Totally 120 six to fourteen years old children with phimosis or redundant prepuce were equally and randomly assigned to receive traditional single-operator circumcision with the stapler (group 1), single-operator circumcision with double suture knots for positioning the cutting plane with the stapler (group 2), or pre-suture ligation plus single-operator suture knot positioning circumcision with the stapler (group 3). We recorded and comparatively analyzed the operation time, intraoperative blood loss and hematoma, the number of residual suture knots, the patients' satisfaction with foreskin reservation, sutured frenulum and incision aesthetics, and the rates of surgical conversion, severe postoperative dysuria, severe wound exudation and perioperative anxiety of the parents and surgeon.
Results:
Statistically significant differences were observed among the three groups in the operation time, intraoperative blood loss, incidence of intraoperative hematoma, number of residual suture knots, the patients' satisfaction with foreskin reservation, sutured frenulum and incision aesthetics, and the rates of surgical conversion, severe postoperative dysuria, severe wound exudation and perioperative anxiety of the parents and surgeon (P < 0.05). Compared with group 1, group 3 showed obviously less operation time and intraoperative blood loss and lower incidence of intraoperative hematoma, number of residual suture knots and rates of surgical conversion and perioperative anxiety of the parents and surgeons, and higher rates of patients' satisfaction with foreskin reservation, sutured frenulum and incision aesthetics. The intraoperative blood loss, incidence of intraoperative hematoma, and the rates of severe postoperative dysuria, severe wound exudation and perioperative anxiety of the parents and surgeon were lower in group 3 than in group 2.
Conclusion:
Pre-suture ligation plus single-operator suture knot positioning circumcision with the stapler helps reduce the operation time, intraoperative blood loss, incidence of intraoperative hematoma, number of residual suture knots and rates of surgical conversion and perioperative anxiety of the parents and surgeon, and increase the patients' satisfaction with foreskin reservation, sutured frenulum and incision aesthetics.
