Manual for Male Circumcision under Local Anaesthesia

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