Sleeve Resection
also called Double Circular Incision

Basis of Method

The foreskin is slid back along the shaft and a freehand cut is made around the shaft as far back as the scar line is to be placed. The foreskin is returned to cover the glans and another cut is made around the shaft at the same position along its length as the first. A longitudinal cut is made between the two circumferential ones and the strip of skin is removed. The edges are then pulled together and sutured. The glans and frenulum are not protected during the procedure. The frenulum can be included in the main cutting, or can be cut separately, or left intact. Results depend very much on the skill of the surgeon, but can be as tight or loose as desired with the scar line anywhere that is wanted. This technique is most commonly used on adults when circumcision is performed by a trained urologist.
Clip Art
More on methodology

There are essentially two versions of this technigue. Many urologists simply remove everything within the strip back to Buck's fascia. This is the method described in MG Lucas [1984] A method of circumcision, British Journal of Urology Vol 56, pages 551-553.

A much more sophisticated version was originally developed by the British urologist Jakob Snowman and is very well described in Private Parts, a Health Book for Men by the Canadian urologist Yosh Taguchi. In this version, only superficial skin is removed. All nerves and blood vessesls are dissected out and allowed to remain, along with the loose connective tissue which underlies the shaft skin. Because of the duration of the procedure, most surgeons will only carry out this method of circumcision under general anaesthetic. Since so little is removed, even in a 'tight' circumcision, healing is rapid and an adult can resume sexual relations in two weeks. The usual outcome is a 'low' circumcision with the frenulum removed, but the method can be tailored for any desired result.

Further illustrations of the method
Explicit photograph Explicit photograph

The following additional resources were used in the preparation of this web page:
UK flag Channel 4 logo Channel 4 TV Series "Embarrassing Bodies" [2011]

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