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General Circumcision Description
|General Circumcision Description:||What follows is a general description of the two most-used methods of infant circumcision: the Gomco Clamp and the Plastibell.|
(Please see the methods page for details of these and other methods.)
The doctor examines the baby's genitals for any abnormalities.
The baby is undressed and laid on a molded plastic board called a Circumstraint. His legs and arms are Velcro'd down at his sides. A surgical drape is placed over his lower body; Betadine is swabbed over the penis and scrotum as an anti-infectant.
After the penis is "popped through" a hole in the "drape", the foreskin's pinpoint opening is grasped and clamped with two needle-nosed clamps called hemostats.
|See beginning of the circumcision video for this step.
All circumcisions --no matter which method is used-- involve the separation of a connective membrane which literally seals the foreskin to the head of the penis from birth, in much the same way that fingernails are attached to nailbeds.This is why babies' and young boys' foreskins cannot -and should not- be retracted.
Holding both these hemostats in one hand to keep the opening wide, the doctor inserts a probe- usually another pair of closed hemostats, or a flat clamp- into this opening and pushes it back and forth and/or opens and closes it repeatedly until all of the foreskin has been torn/separated from the penile head.
Between the two hemostats, the foreskin is clamped lengthwise along the "dorsal" (top) side of the foreskin in the center, to crush the blood vessels and minimize bleeding. All three clamps are left on for a moment to assure this.
The middle clamp is then removed, and scissors are used along the resulting "crush line", splitting the foreskin.
The foreskin is laid back allowing room for the insertion of a metal or plastic bell intended to cover -and therefore protect- the penile head from being injured during the actual "circumcision", or "cutting around".
The foreskin is pulled back up over the bell with the hemostats.
The Gomco Clamp is assembled, pulling the foreskin through a hole in its base and around the bell with tweezers; or, the Plastibell is placed over the penile head and the foreskin pulled over it.(The doctor uses personal judgement about how far to pull the skin up. This is why some boys have some foreskin left over the head, and why some even have some shaft skin taken.)
Notice in the small picture that the dorsal slit is held together by a hemostat while two others pull the foreskin and metal bell up through the hole in the base plate. (See illustration of same step.)
|The Plastibell and its string|
|The Gomco Clamp|
The "nut" of the Gomco Clamp is then tightened, or a string is tied tightly into a special groove in the Plastibell to cut off the blood supply to the foreskin.(Plastibell method pictured at left.)
Once it's blood vessels are sufficiently crushed, the foreskin is finally cut off, either with a scalpel (Gomco method. Pictured at left) or with scissors (Plastibell method).
See the 2nd half of the circumcision video for this step.
The circumcision "proper" is completed; however, the Gomco clamp is left assembled on the penis for at least 5 minutes to allow the blood to clot along the cut line.
The Plastibell's handle is snapped off; the Gomco Clamp is disassembled- the bell being carefully separated from the shaft skin, as "the crush" will make it stick.(Gomco Clamp "crush" pictured at left.)
|Completed GOMCO Clamp circumcision.
See very end of circumcision video for this step.
|The penis is wrapped in some gauze with plenty of Vaseline on it to prevent the penis from sticking to the diaper and/or getting urine and feces in the wound.|
|Completed Plastibell circumcision
||The Plastibell and its string will stay on the penis until the little bit of remaining foreskin in front of the string dies, whereupon the skin, string, and plastic bell will fall off- usually within a week.|