circumcision device is of Australian origin, with quality control for the purposes of CE accreditation overseen by TÜV Rheinland. It claims to be a low-cost, simple-to-use device with the special advantage that the ring cannot migrate proximally and thus dig into tissue that should not be affected by the circumcision procedure. Such migration has, over many years, been reported as a potential problem with the nominally similar Plastibell device in cases where that design has been used for tight styles of circumcision. The Circumplast®
device received FDA clearance for sale and use in the USA on September 18th 2015.
The manufacturer’s notes regarding procedure read as follows:
- Mark the level at which the circumcision is to occur. A local anaesthetic may be used at this time.
- Gently separate the foreskin from the glans.
- Ligate or electrocoagulate the frenulum vessels to avoid bleeding. Retract the foreskin with the frenulum proximally to reveal the glans and allow enough space for the device to be inserted properly.
- Make a dorsal slit long enough to ensure that the Circumplast® device can be inserted (Figure 1).
- Insert the Circumplast® device until the coronal sulcus has been reached. Fix the foreskin to the distal edge of the Circumplast® device with forceps (Figure 2).
- Secure the ligature found in the Circumplast® packaging at the location of the mark made earlier. Break the Circumplast® handle off once the ligature has been secured tightly (Figure 3).
- Excess foreskin should be cut and electrocoagulated. The device will fall off naturally after several days.
Circlist Editorial comment:
It is interesting to note the advice that the frenulum should be removed prior to fitting the ring. It is often felt that this makes for a more comfortable and effective result. Frenulum removal should also help the ring to seat evenly, something often overlooked in commentary about fit-&-wear devices generally.
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