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INOVO Medical’s Circumcision Technique

What is Circumcision?

Circumcision refers to a common operation that removes the foreskin that covers the tip of the penis. It is most often carried out by family, cultural, religious and even for medical reasons.Calque-71

 

 

At INOVO Medical, we only use the latest, most modern circumcision techniques such as Plastibell and Mogen. The procedure itself is performed using a local anesthetic and generally takes a few minutes.

We recommend that you make an appointment for a pre-circumcision consultation, which will take place immediately prior to the circumcision. This consultation allows the doctor to provide a detailed explanation of the procedure and an opportunity to clarify any issues of concern. We do not require a referral.

 

As with any surgical procedure, circumcision carries some risk. Complications are uncommon but may include pain, local infection, and bleeding. Benefits of circumcision include lowering the risk of acquiring sexually transmitted and urinary tract infections and eliminating the risk of infections under the foreskin (balanitis).

“After a comprehensive review of the scientific evidence, the American Academy of Pediatrics found the health benefits of newborn male circumcision outweigh the risk.” See more here

— American Academy of Pediatrics

We are the first and only in the country to use the no needle circumcision technique.

Dr. Bélanger has a background as a chronic pain specialist. This has allowed him to develop a unique technique of anesthesia that replaces the needle-nerve block that is currently used at other clinics. The anesthesia is just as strong yet it does not carry the risk of nerve damage that the typical needle carries, meaning that with our technique, we reduce the discomfort of a needle. There is, however, occasional bruising that occurs with both techniques.

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Methods of Circumcision:

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THE PLASTIBELL – This is the most modern technique. The glans remains protected during the procedure by the ring. Hemostasis (control of bleeding) is effective due to the ligature tie. Cosmetically, a predictable result is obtained due to the straight line of the ligature that causes the wound. It is a quick procedure for the physician to perform. No bandage is required, allowing easy monitoring for infection. Healing occurs while the edges of the prepuce are secured in the ring, making skin bridges (where the foreskin’s end heals to the glans’ corona). (Figure 1)

MOGEN CLAMP – This technique is known for its quickness. The foreskin is stretched forward and through the central slit of the Mogen. Notice that the outline of the glans is safely behind the Mogen. The cut is made along the front surface of the Mogen. (Figure 2)

THE GOMCO CLAMP – This is the most common technique used by physicians. Since it requires more time to perform and involves more tissue handling, it leaves more skin and thus a higher risk of subsequent reconnection of the skin to the glans. (Figure 3)

The use of either technique depends on the expertise of each clinic. In our clinic, we favor the Plastibell technique and we will soon offer the Mogen Clamp Technique as an alternative.

What is the Plastibell Technique?

ligature-plastibell

The Plastibell Circumcision Technique involves the use of a clear plastic ring with a deep groove running circumferentially and is specially designed for circumcising infant males. The Plastibell is placed onto the head of the penis during and the device will fall off within 4 to 8 days.

  1. Anatomy-of-cicumcision-1First, an incision is made on the top of the foreskin. It is called the dorsal slit.
  2. Anatomy-of-cicumcision-2The plastibell is then placed over the glans and under the foreskin.
  3. Anatomy-of-cicumcision-3A ligature is then tied where there is a groove in the plastibell.
  4. Anatomy-of-cicumcision-4The foreskin outside the ligature is trimmed. This is what it looks like after trimming.

What is Mogen Clamp technique?

The entire circumcision (including bandaging) takes under 60 seconds. To calm the baby during the procedure, a sugar filled gauze pacifier is given and soothing music is played in the room.

  1. Anatomy-of-cicumcision-1A profile of the uncircumcised penis with the foreskin covering the glans (head of the penis).
  2. Anatomy-of-cicumcision-2The same penis as in Figure 1 but drawn as if the foreskin was transparent. Here you can see the foreskin in relation to the inner side of the foreskin and the glans. Notice the adhesions ({ ) between the inner side of the glans. These are present at birth in almost all babies and must be released before the actual circumcision.
  3. Anatomy-of-cicumcision-3This shows the foreskin stretched forward and through the central slit of the Mogen. Notice the outline of the glans (shaded —) safely behind the Mogen. The cut is made along the front surface of the Mogen.
  4. Anatomy-of-cicumcision-4This is a diagram featuring the same penis following the circumcision. Notice that the cut edge of the skin retracts to just behind the back rim of the glans (–). This is the site of healing.