Manual for Male Circumcision under Local Anaesthesia
Manual for Male Circumcision under Local Anaesthesia
Manual for Male Circumcision under Local Anaesthesia
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<strong>Male</strong> circumcision <strong>under</strong> local anaesthesia<br />
Version 3.1 (Dec09)<br />
Once the <strong>for</strong>ceps is in position, feel the glans to check that it has not<br />
been accidentally caught in the <strong>for</strong>ceps.<br />
Fig. 5.18 Forceps-guided method. The <strong>for</strong>ceps is applied taking care<br />
not to catch the glans.<br />
Step 6. Using a scalpel, cut away the <strong>for</strong>eskin flush with the outer<br />
aspect of the <strong>for</strong>ceps. The <strong>for</strong>ceps protects the glans from injury, but<br />
nevertheless, particular care is needed at this stage.<br />
Fig. 5.19 Forceps-guided method. Cutting off the <strong>for</strong>eskin.<br />
Step 7. Pull back the skin to expose the raw area. Clip any bleeding<br />
vessels with artery <strong>for</strong>ceps. Take care to catch the blood vessels as<br />
accurately as possible and with minimal adjacent tissue. Tie each<br />
vessel (see Fig. 5.3 and 5.4) or <strong>under</strong>-run with a suture and tie off.<br />
Take care not to place haemostatic stitches too deeply. When dealing<br />
with bleeding in the frenular area or on the <strong>under</strong>side of the penis, care<br />
must be taken not to injure the urethra.<br />
Surgical procedures <strong>for</strong> adults and adolescents Chapter 5-18
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