Biomedical Engineering – From Theory to Applications

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Biomedical Engineering – From Theory to Applications
Website: Tara Medic does not have its own website. See instead:
http://www.circlist.com/instrstechs/taraklamp.html
Category: Ischaemic necrosis device
Fig. 16. The Tara KLamp.
Procedure: The Tara KLamp is the original single-use “clip-&-wear” ischaemic necrosis
device to have gone into commercial production. Procedure for use is substantially the same
as for the Ali's Klamp, Ismail Klamp and SmartKlamp. Since its invention nearly 20 years
ago by Gurchran Singh Tara Singh, the Tara KLamp has undergone a number of design
changes the most notable of which relates to its size, which has reduced considerably, thus
making the current version more convenient to wear than the original.
The latching mechanism of the Tara KLamp is especially secure, making this design suitable
for use on unwilling, meddlesome or autistic boys.
Considerable criticism of the Tara KLamp has arisen in consequence of a paper published by
Lagarde and associates (Lagarde et al., 2009). The authors of the present chapter are in
possession of documentary evidence apparently proving that Lagarde's team did not attend
Tara Medic's training course relating to use of the Tara KLamp. Furthermore, these
documents also appear to show that Lagarde's team departed from the procedure set down
in the package insert. If true, we suggest the resulting criticism of the Tara KLamp to be
unfair and possibly unwarranted. Unpublished studies by the Health Department of
KwaZulu-Natal apparently failed to replicate the problems and the Tara KLamp has now
been accepted as the “preferred device” for use in Kwa-Zulu Natal.
We suggest that, at the very least, Lagarde's findings should be set aside pending further
investigation. Safety and efficacy trials of the Tara KLamp should be repeated by a different
team. Such a trial might usefully address one further issue: Whether or not the Tara KLamp
can be successfully used without the foreskin being severed, instead leaving it to necrotise in
situ as is done with the PrePex device.
11. World Health Organisation’s preference?
Early in 2011 the World Health Organisation formed a Technical Advisory Group (TAG)
with a remit to look at evidence and make recommendations to WHO regarding choice of
circumcision clamp, but to date the TAG has not published any recommendations (Personal
correspondence between co-author C. Eley and the co-Chairman on 21 Feb 2011). It is to be
hoped that, when they do, it will be a shortlist for local consideration rather than a