Surgical paper XIX
Several improvement measures of circumcision
This paper outlines several innovative methods aimed at improving the effectiveness and safety of circumcision surgeries. The techniques include local venous anesthesia of the foreskin, bloodless surgery through arterial blockage, and the use of human hair as a suturing material.
1. Local Venous Anesthesia of the Foreskin
A rubber band is tied around the base of the penis to block venous return, causing the superficial veins of the penis to engorge. A fine needle is used to puncture the subcutaneous vein on the distal side of the penis, and 2 ml of 2% lidocaine is injected after aspirating stagnant blood.
- Provides complete anesthesia.
- Eliminates the risk of foreskin edema due to local anesthesia, thereby ensuring a more accurate resection line.
2. Bloodless Surgery via Blood Supply Blockage
The rubber band at the base of the penis is tightened, blocking the dorsal artery and creating a blood-free surgical field. This facilitates precise and complete cutting of the foreskin. Visible ends of severed blood vessels are first ligated, and then the tourniquet is released, ensuring complete hemostasis.
- Creates a clear, blood-free surgical field.
- Allows for precise cutting and complete hemostasis, aiding the surgical process.
3. Utilizing Human Hair for Suturing
Several strands of long female hair are cut and sterilized by soaking in a disinfectant solution for 5 minutes, followed by a saline rinse. The sterilized hair is then used as suture material.
- Enables flexible suturing of both the inner and outer layers of the foreskin, ensuring a tight and accurate anastomosis.
- Eliminates the need for the conventional 8-point suturing method, reducing contamination and facilitating healing.
- Postoperative suture removal is not necessary as the hair naturally breaks and falls off within 7–10 days.
In a series of 30 cases using these techniques, there were no incidents of wound dehiscence or infection, and all cases achieved Grade I healing.
These improved circumcision techniques offer multiple benefits, including enhanced anesthesia, a cleaner surgical field, and easier postoperative care.
Originally published in "Transportation Medicine Journal" 90; 4(3):66 by Li Mingjie, Changhang Hospital, 1979; 1:70