Manual for Male Circumcision under Local Anaesthesia

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Male circumcision under local anaesthesia Version 3.1 (Dec09) Fig. 5.32 Trimming the inner edge of the foreskin Step 10. Stop any bleeding and suture, as described in steps 7–10 of the forceps-guided method. Step 11. Check for bleeding. If there is none, apply a dressing (see “Dressing” at the end of this chapter). 1 World Health Organization. Surgical care at the district hospital. Geneva, 2003. Surgical procedures for adults and adolescents Chapter 5-26
Male circumcision under local anaesthesia Version 3.1 (Dec09) Sleeve resection method of circumcision The sleeve resection method requires good surgical skill and is better suited to a hospital rather than a clinic setting. The technique requires an assistant. If bipolar diathermy is available the procedure can be virtually bloodless. Although the cosmetic results are better than with the other two techniques, there is more room for surgical error, either by cutting too deep when making the two circular incisions or cutting too deep when dissecting the skin flap free. Step 1. Prepare skin, drape and administer anaesthesia, as described above. Step 2. Retract the foreskin and remove any adhesions, as described above. Step 3. Mark the intended outer line of the incision, as described above (Fig. 5.33), with a V shape, pointed towards the frenulum, on the underside (ventral aspect) of the penis (Fig. 5.34). The apex of the V should correspond with the midline raphe. Fig. 5.33 Marking the line of the outside cut, just below the corona Fig. 5.34 A V is marked on the ventral side (underside) of the penis, with its point towards the frenulum. Surgical procedures for adults and adolescents Chapter 5-27
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Manual for Male Circumcision under Local Anaesthesia

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