Manual for Male Circumcision under Local Anaesthesia

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Male circumcision under local anaesthesia Version 3.1 (Dec09) Fig. 5.27 Superficial incision used to mark the line of incision on a man with deeply pigmented skin. Step 5. Grasp the foreskin with artery forceps at the 3 o’clock and 9 o’clock positions. Take care to apply the artery forceps so that there is equal tension on the inner and outer aspects of the foreskin (Fig 5.28). Fig. 5.28 Tensioning the foreskin. Step 6. Place two artery forceps on the foreskin in the 11 o’clock and 1 o’clock positions (Fig. 5.29). Check that the inside blades of the two artery forceps are lying between the glans and foreskin, and have not been inadvertently passed up the urethral meatus. Fig. 5.29 Placing artery forceps at the 11 o’clock and 1 o’clock positions (In the drawing the forceps in 3 and 9 o’clock positions are not shown). Step 7. Between the two artery forceps, in the 12 o’clock position, use dissection scissors to make a cut (the dorsal slit) up to but not beyond the previously marked incision line (Fig. 5.30). Surgical procedures for adults and adolescents Chapter 5-24
Male circumcision under local anaesthesia Version 3.1 (Dec09) Fig. 5.30 Cutting the dorsal slit Step 8. Using dissection scissors, cut the foreskin free, following the previously marked circumcision line (Fig. 5.31). Fig. 5.31 Cutting away the foreskin with dissection scissors Step 9. Any skin tags on the inner edge of the foreskin can be trimmed to leave approximately 5 mm of skin proximal to the corona (Fig. 5.32). Care must be taken to trim only the skin and not to cut deeper tissue. Surgical procedures for adults and adolescents Chapter 5-25
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Manual for Male Circumcision under Local Anaesthesia

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