Launched in Turkey in 2004, the KirveKlamp appears to be the industry’s first attempt at producing a single-use, all-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 detachable ‘tube’ or ‘handle’ section has subsequently also emerged in the Sunathrone Clamp, detailed elsewhere on this website.
Sizes manufactured: 10mm to 18mm in 2mm increments.
Patient age range: Newborn to immediately
pre-pubescent.
Reportedly no teenage or
adult sizes exist.
The device consists of three parts, called the Inner Ring, the Clamp and the Supporting Handle.
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It is delivered as a sterile package with the Inner Ring and Supporting Handle pre-assembled ready for use. Sizes are color-coded for rapid identification in the surgery, clinic or field.
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The Supporting Handle allows 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 website, a fully ‘low’ cut (inner foreskin totally removed) appears only to be achievable if the frenulum is first cut as a separate procedure. If this is not done, it seems likely that the rim of the Inner Ring will not ‘seat’ 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 is in position, the foreskin is clamped to it using the Clamp ring. Note that adjustment of the position of the Inner Ring determines 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 is closed determines the loose/tight parameter.
The circumcision cut is made close to the distal face of the Clamp ring. However the final scar line will be at the position of the proximal face, several millimeters closer to the abdomen. The tissue beneath the Clamp ring is, 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 is considerably wider than is the case with a Gomco clamp and the crushing persists 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 has been severed, the Supporting Handle is removed. This immediately exposes the tip of the glans. Urine can be voided without it coming into contact with the device and, given the reduced bulk resulting from removal of the handle, underpants or even swimming trunks can be worn normally for the duration of the healing period. This will vary according to the boy’s age but will typically be 3 to 5 days. In most cases the device should drop off by itself, as happens with a Plastibell, but there may be occasions (as with the Sunathrone clamp) where intervention is necessary.
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The device appears to have the potential for achieving a fairly tight cut if required, but possibly not as tight as can be achieved with a Gomco clamp due to the greater width of the KirveKlamp’s crush line.
The absence of the 16mm size from the illustrated Measuring Panel is unexplained.
Manufacturer’s contact details in Turkey are:
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