Manual for Male Circumcision under Local Anaesthesia

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Male circumcision under local anaesthesia Version 3.1 (Dec09) and separate the adhesions to expose the corona, as described above. Step 3. It is usually necessary to make a dorsal slit (as described above) before the Plastibell can be placed on the glans. The slit needs only to be sufficiently long to allow the Plastibell to be placed over the glans. Each Plastibell is supplied in a sterile packet with a ligature – the Plastibell tie. The procedure is easier if, after opening the Plastibell package, the Plastibell tie is placed loosely around the shaft of the penis before the dorsal slit is made (Fig. 6.10). Fig. 6.10 The dorsal slit, allowing access to the glans Step 4. Place the Plastibell on the glans, as shown in Fig. 6.11. Fig. 6.11 Placing the Plastibell on the glans Step 5. Pull the foreskin back over the Plastibell. It is sometimes helpful to hold the foreskin in position by clipping it to the Plastibell handle with an artery forceps (Fig. 6.12). Infant and paediatric circumcision Chapter 6 - 14
Male circumcision under local anaesthesia Version 3.1 (Dec09) Fig. 6.12 An artery forceps is used to secure the foreskin to the handle of the Plastibell .. Step 6. Carefully place the ligature in the groove of the Plastibell. Ensure that it is in the correct position, then pull it tight and tie. Cut off the foreskin using scissors, leaving 1– 2 mm of cuff to prevent the ligature from slipping off (Fig 6.13). Fig. 6.13 Cutting away the foreskin Step 7. Snap off the handle of the Plastibell (Fig 6.14). Infant and paediatric circumcision Chapter 6 - 15
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Manual for Male Circumcision under Local Anaesthesia

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