Sutureless and Scalpel-Free Circumcision—More Rapid, Less Expensive and Better?

Abstract

Combined electrocautery and 2-octyl cyanoacrylate for circumcision is a safe, efficient, financially beneficial, cosmetically appealing alternative to traditional circumcision done with scalpel and sutures.

Paediatric sutureless circumcision—an alternative to the standard technique

“…The same group later published their data on 493 primary sutureless circumcisions, where similar to our technique, they began using electrocautery. This technique resulted in significant savings for Elmore's department in terms of time and cost, with similar, comparable complication rates [18]. However, they employed the use of a monopolar device, whereas our technique incorporates the use of bipolar diathermy for meticulous haemostasis.…”

Rapid, minimally invasive adult voluntary male circumcision: A randomised trial

“…The time savings associated with the Gomco technique are likely to substantially reduce overall cost and assist in mass scale-up. [19] In mass circumcision settings, use of the Gomco instrument could increase productivity more than is indicated by the time advantage to perform the procedure. It takes 1 -2 min to place the Gomco instrument, and 2 -3 min to remove it and apply the adhesive.…”

Circumcision - what’s wrong with plastic rings?

“…[18][19][20][21] A systematic review of randomised controlled circumcision trials showed that, compared with sutures, tissue adhesive reduces operative time, improves cosmetic result, and increases patient satisfaction. 19 Adverse effects reported from tissue adhesive are minor and include wound separation, wound inflammation, and inadvertent incorporation of surrounding structures such as scrotal skin and hair into the wound.…”

“…19 The incision rarely bleeds, there is little postoperative swelling, and the adhesive is strong enough so the excision line does not separate during erections. 18,20 In most studies, the surgeons excised the foreskin using laser or diathermy, but several small studies used the combination of Gomco clamp and tissue adhesive in children and adults. 18,21,22 The simple combination of Gomco clamp circumcision coupled with tissue adhesive results in a procedure that is bloodless and sutureless, simple to learn, rapid and applicable to all age groups, and heals quickly with excellent cosmetic results.…”