Mogen Clamp

Bronstein, a Brooklyn Mohel (ritual circumcisor),who invented the Mogen Clamp, also invented the Nutech clamp. The Mogen Clamp is a variation of the Kantor clamp. Instead of crushing the tissue by the attached hemostat, the Mogen shield acts as the clamp. It has the shortcomings of the Kantor clamp, plus 1 uniquely its own: with the glans below completely out of sight, there is a chance that the tip of the glans might be caught in the clamp. However, this is the preferred device of the more modern Jewish Mohel, and is newly reported to cause less discomfort when used during infant circumcision, than does the Gomco Clamp.

THE MOGEN MALE CIRCUMCISION TECHNIQUE:

1. Stretch the preputial opening.

2. Break preputial adhesions so that the foreskin is completely retractile using a blunt-edged probe.

3. Lift the prepuce in an upward and outward direction with a hemostat. This action should cause the glans to retract towards the scrotum, preventing accidental amputation of the glans.

4. Place the open jaws of the Mogen clamp around the prepuce (grooved side facing the glans) and lift upwards.

5. Close the clamp. It should be left closed for one to one and one-half minutes. If the infant is more than 6 months old it should remain closed for no less than five minutes.

6. While the clamp is closed, excise the prepuce distal to the clamp.

7. Open the clamp slowly and remove it from the penis.

8. Apply downward pressure to the preputial skin around the corona until the skin-mucosal seal is broken and the glans is liberated.

9. Apply antiseptic ointment (Betadine) to the crush line. Apply a light dressing or loin cloth arrangement to keep the ointment from rubbing off.

10. If you remove the clamp prematurely, the crushed edges may separateand bleeding will occur. When this occurs, suture the mucocutanceous margin, being careful to avoid deep sutures that might penetrate the urethra. If the whole edge separates, treat as a freehand circumcision, placing quadrant sutures and sewing between them with fine stitches.

11. Have the baby watched for any sign of bleeding.

12. Bleeding is one of the most common complications and can also becontrolled by applying gentle circumferential pressure with gauze or a sponge or by using absorbable gelatin sponge (Gelfoam), topical thrombin,epinephrine-soaked gauze or sutures.

If you are choosing to have your newborn circumcised, you may want to consult with the doctor who will be performing the circumcision as to what technique he employs. There are several, and you may wish to choose a method other than that of the Mogen Clamp. Some have noted that they believe that the Mogen Clamp is swifter, removes less tissue, leaves more mucosa and doesn't necessarily destroy the frenum.

I understand from a Jewish friend that the Mogen Clamp, although, I think, designed by a Jew, should not be used in a Bris because it crushes the skin preventing blood loss and Jewish circumcision requires the shedding of blood, however small. It is used very effectively by Dr Pollock of Canada in his video. I've posted a series showing a Mogen circumcision - some have appeared before, but worth repeating.

Note: This device should not be used to do a self-circumcision. Circumcision should always be performed by a trained and skilled healthcare provider.

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