Pediatric Surgery International

, Volume 26, Issue 7, pp 739–745 | Cite as

Minimally invasive circumcision with a novel plastic clamp technique: a review of 7,500 cases

Original Article
First Online:
Accepted:

Abstract

Purpose

We aimed to analyze the outcome of circumcisions performed with a new minimally invasive circumcision device.

Methods

This is the first study, which reports the results of 7,500 children circumcised with minimally invasive technique utilizing a plastic clamp device (Ali’s clamp®) in our country. The results of this technique are compared to those of 5,700 children who underwent conventional circumcision.

Results

The most common complication encountered after minimally invasive circumcision technique was found to be buried penis (1.04%). The second complication observed was infection (0.6%), which was significantly lower than the conventional group (p < 0.001). The third complication in plastic clamp group was bleeding with a rate of 0.4%. Bleeding was found to be the most common complication seen after conventional circumcision (5%) and was significantly higher than that of the plastic clamp group (p < 0.001). Total number of complications seen after plastic clamp technique was 2% when compared with 10.4% complication rate occurred after conventional circumcision (p < 0.001). The mean duration of circumcision time with plastic clamp technique was 4.5 ± 1.5 min whereas with conventional circumcision it was 23 ± 4 min (p < 0.0001).

Conclusion

Minimally invasive circumcision technique utilizing plastic clamp significantly reduced the complication rates. The cosmetic appearance after circumcisions performed with this technique was observed to be better than the conventional circumcisions. Due to reduced complications, as well as short duration and ease of application, the minimally invasive technique is suggested as the circumcision procedure of choice.

Keywords

Circumcision Minimally invasive Complications Ali’s clamp technique 
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References

  1. 1.
    O’Brien TR, Calle EE, Poole WK (1995) Incidence of neonatal circumcision in Atlanta, 1985–1986. South Med J 88:411–415PubMedGoogle Scholar
  2. 2.
    Laumann EO, Masi CM, Zuckerman EW (1997) Circumcision in the United States. Prevalence, prophylactic effects, and sexual practice. JAMA 277:1052–1057CrossRefPubMedGoogle Scholar
  3. 3.
    Schoen EJ (1990) The status of circumcision of newborns. N Engl J Med 322:1308–1312PubMedGoogle Scholar
  4. 4.
    Singh-Grewal D, Macdessi J, Craig J (2005) Circumcision for the prevention of urinary tract infection in boys: a systematic review of randomised trials and observational studies. Arch Dis Child 90:853–858CrossRefPubMedGoogle Scholar
  5. 5.
    Seyam RM, Bissada NK, Mokhtar AA, Mourad WA, Aslam M, Elkum N, Kattan SA, Hanash KA (2006) Outcome of penile cancer in circumcised men. J Urol 175:6–557CrossRefGoogle Scholar
  6. 6.
    Gray R, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, Kiwanuka N, Moulton L, Chaudhary M, Chen M (2007) Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet 369:657–666CrossRefPubMedGoogle Scholar
  7. 7.
    Williams N, Kapila L (1993) Complications of circumcision. Br J Surg 80:1231–1236CrossRefPubMedGoogle Scholar
  8. 8.
    Ahmed A, Mbibi NH, Dawam D, Kalayi GD (1999) Complications of traditional male circumcision. Ann Trop Paediatr 19:113–117CrossRefPubMedGoogle Scholar
  9. 9.
    Ben Chaim J, Livne PM, Binyamini J, Hardak B, Ben-Meir D, Mor Y (2005) Complications of circumcision in Israel: a one year multicenter survey. Isr Med Assoc J 7:368–370PubMedGoogle Scholar
  10. 10.
    Yellin HS (1935) Bloodless circumcision of the newborn. Am J Obstet Gynecol 30:146Google Scholar
  11. 11.
    Johnsonbaugh RE, Meyer BP, Catalano JD (1969) Complication of a circumcision performed with a plastic bell clamp. Am J Dis Child 118:781PubMedGoogle Scholar
  12. 12.
    Peng YF, Cheng Y, Wang GY, Wang SQ, Jia C, Yang BH, Zhu R, Jian SC, Li QW, Geng DW (2008) Clinical application of a new device for minimally invasive circumcision. Asian J Androl 10:447–454CrossRefPubMedGoogle Scholar
  13. 13.
    Elder JS (2007) Circumcision. BJU Int 99:1553–1564CrossRefPubMedGoogle Scholar
  14. 14.
    Doyle D (2005) Ritual male circumcision: a brief history. J R Coll Physicians Edinb 35:279–285PubMedGoogle Scholar
  15. 15.
    Wiswell TE, Tencer HL, Welch CA, Chamberlain JL (1993) Circumcision in children beyond the neonatal period. Pediatrics 92:791–793PubMedGoogle Scholar
  16. 16.
    Hardner GJ, Bhanalaph T, Murphy GP, Albert DJ, Moore RH (1972) Carcinoma of the penis: analysis of therapy in 100 consecutive cases. J Urol 108:428–430PubMedGoogle Scholar
  17. 17.
    Shaffer DN, Bautista CT, Sateren WB, Sawe FK, Kiplangat SC, Miruka AO, Renzullo PO, Scott PT, Robb ML, Michael NL, Birx DL (2007) The protective effect of circumcision on HIV incidence in rural low-risk men circumcised predominantly by traditional circumcisers in Kenya: two-year follow-up of the Kericho HIV Cohort Study. J Acquir Immune Defic Syndr 45:371–379CrossRefPubMedGoogle Scholar
  18. 18.
    Gee WF, Ansell JS (1976) Neonatal circumcision: a ten-year overview: with comparison of the Gomco clamp and the Plastibell device. Pediatrics 58:824–827PubMedGoogle Scholar
  19. 19.
    al-Samarrai AY, Mofti AB, Crankson SJ, Jawad A, Haque K, al-Meshari A (1988) A review of a Plastibell device in neonatal circumcision in 2,000 instances. Surg Gynecol Obstet 167:341–343PubMedGoogle Scholar
  20. 20.
    Ahmed A (2007) Childhood circumcision: a planned approach. Trop Doct 37:239–241CrossRefPubMedGoogle Scholar
  21. 21.
    Fraser IA, Allen MJ, Bagshaw PF, Johnstone M (1981) A randomized trial to assess childhood circumcision with the Plastibell device compared to a conventional dissection technique. Br J Surg 68:593–595CrossRefPubMedGoogle Scholar
  22. 22.
    Kaplan GW (1983) Complications of circumcision. Urol Clin North Am 10:543–549PubMedGoogle Scholar
  23. 23.
    Atiker MK, Geçit I, Yüzgeç V, Yalçın O (2005) Complicationsa of circumcision performed within and outside the hospital. Int Urol Nephrol 37:97–99CrossRefGoogle Scholar
  24. 24.
    Lerman SE, Liao JC (2001) Neonatal circumcision. Pediatr Clin North Am 48:1539–1557CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Ferda M. Senel
    • 1
  • Mustafa Demirelli
    • 2
  • Sehmuz Oztek
    • 3
  1. 1.Dr. Sami Ulus Children’s HospitalAnkaraTurkey
  2. 2.Elif Medical CenterAnkaraTurkey
  3. 3.GAP Circumcision ClinicGaziantepTurkey

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