Biomedical Engineering – From Theory to Applications

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Biomedical Engineering – From Theory to Applications
The same inventor has also obtained a patent in respect of another, more recent but very
different design. The relevant patent is CN2009/000406. It is unclear whether the later
design is intended to supersede the original, or compete with it.
10.6 SmartKlamp
Inventor: Ten Have, H.F.
Primary patent: MY0100375
Patent priority date: 30 Jan 2001
Patient age range: Full-term neonate to mid-puberty
Website: http://smartcircumcision.com/index.html
Category: Ischaemic necrosis device
Fig. 14. The SmartKlamp.
Procedure: The SmartKlamp is an ischaemic necrosis device functioning in broadly the same
way as the Ali's Klamp, Ismail Klamp and Tara KLamp.
Since its invention by Henri Ferdinand Ten Have, the commercial history of the
SmartKlamp has to some extent interfered with its development and availability. Originally
produced only in child sizes by the Dutch company Circumvent BV (Hengelo, The
Netherlands), supply ceased when Circumvent BV went into liquidation, having apparently
over-spent on research and development of the adult model. It should perhaps be noted that
Circumvent's experimental adult device had an angled clamping ring similar in principle to
that now found in the Ali's Klamp.
The apparently identical product in child sizes has now appeared in Malaysia, marketed by
a supplier called Smartcircumcision. Aldemir and co-workers described the device thus:
"This fits on the penis much as the others do. After 4 days the connection between its inner
tube and casing is cut and removed. The inner tube is then left to fall off spontaneously in
time. Median operative time is 8 minutes, compared with 18 minutes for conventional
dissection, and cosmetic result, judged blinded by a urologist, was better. Parents'
satisfaction scores were the same" (Aldemir et al., 2008).
The SmartKlamp differs from the Ali's Klamp only in one significant respect: The clamping
ring is not angled to match the typical slant of the coronal rim of the glans. In theory this
achieves less satisfactory capture of inner foreskin ventrally, but the original manufacturer
claimed it is possible to adjust the foreskin to compensate. The SmartKlamp apparently
shares with the Ali's Klamp one notable design weakness. An unwilling or meddlesome
patient could, in theory, open the clamp by placing a flat object such as a table knife between
the tube and the locking arms and then twisting. Additionally, such action would render the