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Circumcision Malaysia

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Stapler Circumcision

Circumcision Anastomat Stapler

Circumcision staplers are disposable medical instruments that have been used for rapid, safe and efficient removal of the foreskin (prepuce) since earlier this decade and they became popular over the past few years. These devices cut as they close the wound in a precise manner using small metal clips.

Studies have shown that this device is superior to conventional methods in many ways including operative time, blood loss, percentage of complications such as wound infection and dehiscence and almost guaranteed good cosmetic outcome.

The stapler comes in nine different sizes to ensure the best outcome each and every single time the procedure is performed.

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The Procedure

 

Before the procedure, patient will have to undergo:

 

  • Consent taking, during which the steps below will be explained in addition to possible complications, healing period and management and wound care.
 
  • After obtaining the written consent, the patient will undergo measurement to decide the most suitable device size for the patient.
 
  • Local anesthesia will then be applied which will be done through either using topical anesthetic creams or via injection of anesthetics to block the penile nerve in case topical creams were not usable such as in case of moderate to severe tightness of the foreskin (phimosis).
 
  • After confirming the numbing effect of the anesthetics, areas of interest will be cleaned with antiseptic solutions.
 
  • An incision might be made at the foreskin to facilitate the insertion of the inner bell.
 
  • Once the inner bell is inserted and its correct position is confirmed to cover the glans penis it will be fixed to the foreskin by using a surgical tie.
 
  • The inner bell is then screwed into the outer bell and once again the correct positions of the bells are confirmed.
 
  • Safety pin is then removed and the stapler will be fired and held for 3 minutes to ensure clean cut of the foreskin and compression of cutaneous and superficial blood vessels.
 
  • Inner bell will be partially released after that to determine complete transaction of the foreskin and absolute haemostasis (absence of any bleeding points).
 
  • Wound is then cleaned again with antiseptic solutions and covered with antibiotic cream.
 
  • Penis is then bandaged using special compression bandages.
 
  • Patient is then discharged home with painkillers and antibiotics

What to look out for (possible complications)

Before undergoing stapler circumcision; your physician will inform you of a list of possible complications, among those:

  1. Bleeding: It’s not uncommon for a patient who underwent this procedure to have bleeding that ranges between small ooze to profuse bleeding from the staples site. Bleeding usually resolves with minimal intervention however in some cases it might require you to meet your physician on a short notice.
  2. Edema: Following the procedure, some fluids might be trapped in the tissue surrounding the wound site as a result of undergoing inflammation after the surgical removal of the foreskin. This is a common complication and it can be avoided easily by using special dressing. Severe cases have to be managed with topical and oral medications.
  3. Pain: It’s very common for patients who undergo circumcision to experience pain during the recovery period, although it’s significantly lesser in the case of stapler circumcision when it’s compared to conventional method, however, considerable numbers of patients might experience it.
  4. Wound infection: Improper management and wound care might results in infection of the wound and discharge, in addition it might lead to
  5. Wound dehiscence: Although undergoing circumcision with this method is considered by most of individuals who would like to avoid suturing (sutureless circumcision technique) however, in some cases the wound edges might fail to close, in this scenario your physician might decide to close the wound gaping using sutures.
  6. Residual staples: The staples in our used staple device are held together with silicon ring; usually the stapler together with the ring might fall around day 10-14 post procedure. Nevertheless, some staples might remain embedded at the wound edges and will require being removed individually by your physician, and he/she needs to inform you of this possible complication prior to the procedure.

Follow-up

Patients will usually be given a date to come back and undergo wound inspection within 2-3 days post procedure during which the compression bandage is removed and the wound will be examined for any possible bleeding or infection. Wounds will usually be left open in most of the cases and patients will be taught on how to carry on a proper wound care in the comfort of their homes. In about 14 days after the procedure; the staples that are held together by a silicon cascade will detach.

Patients are usually advised not to practice any kind of sexual intimacy until a period of 1 month is passed.

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