Manual for Male Circumcision under Local Anaesthesia

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Male circumcision under local anaesthesia Version 3.1 (Dec09) Step 4. Retract the foreskin and mark the inner (mucosal) incision line, 1–2 mm proximal to the corona. At the frenulum, the incision line crosses horizontally (Fig. 5.35). Fig. 5.35 Marking the inner incision line Step 5. Using a scalpel, make incisions along the marked lines, taking care to cut through the skin to the subcutaneous tissue but not deeper (Fig. 5.36, 5.37 and 5.38). As the incision is made, the assistant should retract the skin with a moist gauze swab. Fig. 5.36. Incising along the marked line Fig. 5.37 Incising the V shape on the underside of the penis Surgical procedures for adults and adolescents Chapter 5-28
Male circumcision under local anaesthesia Version 3.1 (Dec09) Any significant bleeding vessels should be clipped with an artery forceps and tied or secured with an under-running suture. Provided the cut has not been made too deeply, most bleeding will be from the skin edge and can be stopped by simple pressure over a swab. Fig. 5.38 Completed incisions leaving a sleeve of foreskin Step 6. Cut the skin between the proximal and distal incisions with scissors, as shown in Fig. 5.39. Fig. 5.39 Cutting the skin between the two incisions Step 7. Hold the sleeve of foreskin under tension with two artery forceps, and dissect the skin from the shaft of the penis, using dissection scissors (Fig. 5.40). Surgical procedures for adults and adolescents Chapter 5-29
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Manual for Male Circumcision under Local Anaesthesia

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