The “Circumcision Template”
Devised by US Army urologists, this device is - as its name suggests - a template and not a fit-&-wear clamp. It still requires the circumciser to have suturing skills. Although similar in appearance to the paediatric Plastibell device, the template does not remain attached to the patient during the healing period.
The equipment needed for the template circumcision procedure is minimal, consisting of 2 forceps, 2 Alice clamps, 1 No. 15
scalpel, a suture needle holder, a 0 nonabsorbable crimping suture or its equivalent and the template. After administration of local anaesthesia, the foreskin is retracted to expose the glans. The size of template is chosen such that the circumference of the glans is 2-3 mm larger than the template. This ensures that the correct amount of skin is removed. If needed, a dorsal slit can be performed. The foreskin is then extended over the template device. The developers of the device report no cases in which a dorsal slit made the procedure more difficult or incapable of being completed with the template.
Next, a crimping suture is tied around the penis in such a position as to align with the groove of the device. The foreskin is then removed (by cutting distal to the suture with cautery or knife using the template as a guide) and discarded. The device is then removed from the penis by cutting the crimping suture, and the skin edges are immediately reapproximated with interrupted absorbable suture.
The Circumcision Template has so far been approved by the USFDA for experimental use only. It is not commercially available.
Decastro B, Gurski J and Peterson A. Adult Template Circumcision: A Prospective, Randomized, Patient-blinded, Comparative Study Evaluating the Safety and Efficacy of a Novel Circumcision Device. UROLOGY 76: 810–814, 2010.
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