Neonatal circumcision techniques
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Published on: November 30, 2010
J R Holman1, E L Lewis, R L Ringler
1Puget Sound Naval Hospital, Bremerton, WA 98312, USA.
Insights
Neonatal circumcision involves three main techniques: Mogen clamp, Gomco clamp, and Plastibell device. Careful patient selection, informed consent, and aseptic measures are crucial for safe infant circumcision procedures.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Urology
Background:
- Neonatal circumcision is a common procedure.
- Three primary methods are widely used: Mogen clamp, Gomco clamp, and Plastibell device.
- Patient selection and preparation are critical for all techniques.
Purpose of the Study:
- To outline the common techniques for neonatal circumcision.
- To emphasize essential procedural considerations.
- To highlight potential complications.
Main Methods:
- Description of Mogen clamp and Gomco clamp techniques, involving glans protection and preputial crushing.
- Description of the Plastibell device technique, inducing tissue necrosis for sloughing.
- Emphasis on universal requirements: aseptic technique, anesthesia, and infant positioning.
Main Results:
- Mogen and Gomco clamps protect the glans while excising the prepuce.
- Plastibell device leads to necrotic tissue sloughing within approximately one week.
- Complications, though rare, include hemorrhage, infection, sepsis, meatal ulceration, and cosmetic issues.
Conclusions:
- Successful neonatal circumcision relies on careful technique selection and execution.
- Informed parental consent regarding medical and social implications is paramount.
- Awareness of potential rare complications is essential for patient safety.
Abstract:
Neonatal circumcision is most commonly performed using one of three techniques--the Mogen clamp, the Gomco clamp or the Plastibell device. With all three techniques, careful selection and preparation of patients is essential. Informed consent must be obtained from parents or guardians, based on an objective understanding of the medical and social implications of circumcision, including potential complications from the procedure. Measures for creating an aseptic field, anesthesia and positioning of the infant do not vary with the technique selected. Both the Mogen and Gomco clamps protect the glans while producing crush injury to the prepuce, which is then surgically removed. The Plastibell device induces necrotic tissue, which is sloughed off, along with the plastic shield, within a week or so. Although complications from neonatal circumcision are rare, hemorrhage, local infection, sepsis, meatal ulceration and poor cosmetic results have been reported.
