Forceps Guided Method

Using the Forcepts Guided Method, the foreskin is pulled forward and clamps are placed along it to determine and deliniate where the limits of the cut are to be. A large pair of forceps (Artery forceps) is then clamped across the foreskin at the place where the cut is to be made. The smaller clamps are removed and the scalpel run across the top of the big forceps. This method doesn't automatically result in a straight smooth line and there is no pre-sealing of the cut edges. Bleeding is more profuse and more stitches may be required than with other methods. This form of cutting is very similar in principle to the scalpel and shield used in a Jewish baby's Bris.

One common method of circumcision is to pull the foreskin forward and hold it in a pair of clamp forceps, placed at an angle parallel to the base of the glans, not straight. The cut is made above and along the blades of the forceps. The forceps have the dual function of stopping bleeding and safeguarding the glans. The final cut will be moderately loose, with a lot of inner skin left so that the scar is well down (or up) the shaft. There will be a V pointing towards the tip on the ventral (under) side of the penis, and a matching V pointing towards the base on the dorsal (upper) side of the penis. The frenulum will still be present.

This style of circumcision was popular in England and my best friend at school had a cut like this, though his scar was so inconspicuous that you had to look hard to see it. Since it is hard to stretch the skin exactly equally, one or other V may be more prominent, and there may be other irregularities in the scar line.

This technique also seems popular in Africa and the Indian subcontinent among the medical profession, (see O. Awojobi, Sutureless circumcision. Tropical Doctor 22, p 124).

This is a close relative of the Shield and Knife method for older children and adults. The foreskin is pulled out in front of the glans and a pair of stout locking forceps is clamped across it, parallel to the corona of the glans and immediately in front of the glans. The scalpel is run across the face of the forceps furthest from the glans to remove the foreskin.

The glans is protected by the forceps. This method does not cut the frenulum but it can be removed before or after the circumcision if desired. The tightness and relative amounts of inner and outer foreskin remaining depend on adjustments made before the forceps are fully closed. The minimum amount of inner skin remaining equals the length of the glans.

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