Launched in Turkey in 2004, the KirveKlamp appears to have been the industry’s first attempt at producing a single use plastic fit-&-wear device that does not protrude beyond the tip of glans once the initial surgery has been completed. The same general concept of a bayonet-jointed detachable ‘tube’ or ‘handle’ section has subsequently also emerged in the Sunathrone Clamp
, detailed elsewhere on this website.
As of 2009, the company developing this product appears to have withdrawn from the market.
Sizes manufactured were 10mm to 18mm in 2mm increments, representing a patient age range of newborn to immediately pre-pubescent.That is the normal age range for circumcision in Turkey.
The device consisted of three parts, called the Inner Ring, the Clamp and the Supporting Handle. Click on the image to enlarge it, use the Back button of your Browser to return to this page.
The device was delivered as a sterile package with the Inner Ring and Supporting Handle pre-assembled ready for use. Sizes were color-coded for rapid identification in the surgery, clinic or field.
The Supporting Handle allowed the user to position the Inner Ring beneath the prepuce at a depth and with an accuracy that would be unattainable using the Inner Ring alone. Although not acknowledged on the manufacturer’s former website, a fully ‘low’ cut (inner foreskin totally removed) appears only to have been achievable if the frenulum was first cut as a separate procedure. If this was not done, it seems likely that the rim of the Inner Ring would not have seated properly in the ventral position, being pushed forward – and thus out of position – by the frenulum, resulting in some inner mucosal lining remaining.
Once the Inner Ring was in position, the foreskin was clamped to it using the Clamp ring. Note that adjustment of the position of the Inner Ring determined the high/low parameter of the resulting style of the circumcision, whilst the amount of shaft skin drawn forward onto the Supporting Handle before the Clamp ring was closed determined the loose/tight parameter.
The circumcision cut was made close to the distal face of the Clamp ring. However the final scar line would be at the position of the proximal face, several millimeters closer to the abdomen. The tissue beneath the Clamp ring was, according to the general concept of the device, expected to necrotize.
No images have yet been traced showing the cosmetic appearance of a fully-healed scar resulting from use of the KirveKlamp. Given that the crush zone was considerably wider than is the case with a Gomco clamp and the crushing persisted over a much longer period – days rather than minutes – the appearance is unlikely to be the same and perhaps more akin to the result of the Sunathrone clamp.
Once the foreskin had been severed, the Supporting Handle was removed. This immediately exposed the tip of the glans, allowing urine to be voided without it coming into contact with the device. Given the reduced bulk resulting from removal of the handle, underpants or even swimming trunks could be worn normally for the duration of the healing period. As with other clip-&-wear clamps the time interval would have varied according to the boy’s age. 5 days would be typical. In most cases the device should have dropped off by itself, as happens with a Plastibell, but there may also have been occasions (as with the Sunathrone clamp) where intervention was necessary.
The device appears to have had the potential for achieving a fairly tight cut if required, but possibly not as tight as can be achieved with a Gomco clamp (multi-use) or Ismail clamp (single use) due to the greater width of the KirveKlamp’s crush line.
The absence of the 16mm size from the illustrated Measuring Panel is unexplained.
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