||Harry Bronstein, a Brooklyn mohel (ritual circumcisor) invented the Mogen Clamp. It is now the preferred device of the more modern Jewish Mohel but is also one of the most widely used devices for routine infant circumcision in the USA, rivalling the Gomco clamp. It is reported to cause less discomfort when used during infant circumcision than does the Gomco Clamp.
The Mogen circumcision technique
- Stretch the preputial opening.
- Break preputial adhesions so that the foreskin is completely retractile, using a blunt-edged probe.
- Lift the prepuce in an upward and outward direction with a hemostat. This action should cause the glans to retract towards the scrotum, preventing damage to the glans.
- Place the open jaws of the Mogen clamp around the prepuce (grooved side facing the glans) and lift upwards.
- Close the clamp. Affixed to a newborn, it should be left closed for one to one and one-half minutes. If the infant is more than 6 months old it should remain closed for no less than five minutes.
- While the clamp is closed, excise the prepuce distal to the clamp.
- Open the clamp slowly and remove it from the penis.
- Apply downward pressure to the preputial skin around the corona until the skin-mucosal seal is broken and the glans is liberated.
- Apply antiseptic ointment (Betadine or similar) to the crush line. Apply a light dressing or loin cloth arrangement to keep the ointment from rubbing off.
- If you remove the clamp prematurely, the crushed edges may separate and bleeding will occur. In this eventuality, suture the mucocutanceous margin.
- Have the baby watched for any sign of bleeding.
- Bleeding is one of the most common complications and can also be controlled by applying gentle circumferential pressure with gauze or a sponge or by using absorbable gelatin sponge (Gelfoam), topical thrombin, epinephrine-soaked gauze or sutures.
If you are choosing to have your newborn circumcised, you may want to consult with the doctor who will be performing the circumcision as to what technique he employs.
Mogen Clamp circumcision of an infant, illustrated
There is some debate amongst religious jews concerning use of this clamp for the 8th day of life ceremony called the Bris. The crushing action of the clamp may totally prevent blood loss, contrary to the religious requirement that blood is shed.
Adult circumcision by Mogen Clamp, illustrated
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Which one - Gomco or Mogen?
Two recent American papers report that virtually all hospital neonatal circumcisions are carried out either by Mogen or Gomco, with the two clamps pretty much equal in popularity. Complication rates are very low with both. The consecutive short papers are in Hospital Pediatrics
and present results from thousands of neonatal circumcisions. Both papers are free downloads.
The following resources were used in the preparation of this web page:
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