Manual for Male Circumcision under Local Anaesthesia

Male circumcision under local anaesthesia
Version 3.1 (Dec09)
The Mogen clamp method
The Mogen clamp is widely used. There have been several
studies comparing it with the Gomco clamp, another widely
used device. The Mogen (“shield”) clamp compares favourably,
because it is easy to use and has no parts to assemble. The
fewest complications with this method have been reported in
the context of circumcision of 8-day-old babies. Since the
Mogen clamp is reusable, careful precautions have to be taken
to ensure the device is properly cleaned and sterilized between
procedures. Also there is a risk that the glans can be pulled
into the slit and crushed or partially severed. i
Fig. 6.15 The Mogen clamp
Step 1. After cleaning, draping, anaesthesia and marking the
line of the circumcision over the corona, retract the foreskin
and separate the adhesions to expose the corona, as
described above.
It is important to separate all adhesions in order to prevent the
glans from getting accidentally pulled into the Mogen clamp
and injured.
Step 2. Put traction on the foreskin, and introduce it into the slit
in the device, with the concavity facing the glans (Fig 6.16). It
is important to ensure that the glans is not pulled into the slit. j
If there is any doubt, remove the clamp, inspect the glans for
any sign of crushing injury and reapply the clamp.
i
j
Strimling BS: Partial amputation of glans penis during circumcision. Pediatrics 97: 134-136,
1995
Strimling BS: Partial amputation of glans penis during circumcision. Pediatrics 97: 134-136,
1995
Infant and paediatric circumcision Chapter 6 - 17