Anesthesia for circumcision surgery

The foreskin is an important component of the male penis, and its main function is to protect the male glans. Of course, if the foreskin is too long, it is not a good thing for men, because it may cause various diseases and affect the quality of men's sexual life. For this reason, many people choose to undergo circumcision surgery. Next, I will introduce to you the specific methods of circumcision surgery!

1. One-time circumcision method

(1) Separation of adhesions between the foreskin and glans penis: Before circumcision, check whether the foreskin and glans penis are adhered. If so, they should be separated first.

(2) Traction and fixation of the foreskin: Place the foreskin in a natural position and clamp it with two vascular clamps at the center of the dorsal and ventral sides of the foreskin, with a distance of about 0.5 cm between the two clamps.

(3) Cut open the dorsal and ventral foreskin longitudinally: The assistant uses his left hand to press and pinch the base of the penis to temporarily stop the bleeding. Then lift up the two vascular clamps in the middle of the dorsal side, and the operator uses scissors to cut the foreskin longitudinally between the two clamps until it is 0.5 to 0.8 cm away from the coronal sulcus. Then lift the two vascular clamps in the middle of the ventral side and cut the ventral foreskin in the same way. The length of the foreskin retained at the frenulum is slightly longer than that on the dorsal side by 0.2 to 0.3 cm. Be careful not to damage the frenulum when cutting.

(4) Circumcision: After the dorsal and ventral foreskin are cut longitudinally, the glans penis and the coronal sulcus can be exposed. Pull the two vascular clamps on the right side with force, and use scissors to cut off the excess foreskin from the longitudinal incision on the dorsal side of the foreskin, 0.5 to 0.8 cm away from the coronal sulcus, until the ventral longitudinal incision. Then pull the two vascular clamps on the left side forcefully and use the same method to circularly remove the left half of the foreskin.

(5) Ligation to stop bleeding: After circumcision, the assistant relaxes his left hand and quickly pushes the foreskin down toward the base of the penis to expose the wound surface, and then ligates the bleeding point with No. 3-0 fine silk thread.

(6) Suturing the incision: Suture the inner and outer layers of the foreskin in place. Use fine silk thread to first suture one mattress-style stitch at the frenulum, then suture one stitch each at the center of the back and the center points of the left and right sides. Tie a knot with these four stitches and keep the thread tails. Then add 1 to 2 stitches between every two threads. Cut the stitches short after tying the knot.

(7) Bandaging the incision: Fold the Vaseline gauze into a strip and wrap it around the foreskin incision. Secure it with the tail of the suture with 4 stitches on the top, bottom, left and right sides. Then wrap it with gauze outside the oil gauze and secure it with adhesive tape, leaving the glans penis exposed.

2. Circular cutting of inner and outer plates

(1) Draw the outer plate incision line: When the foreskin is tension-free, draw the outer plate incision line parallel to the coronal sulcus at the foreskin about 0.5 cm distal to the coronal sulcus.

(2) Draw the inner plate incision line: Flip the foreskin over the coronal sulcus to expose the coronal sulcus, flatten the inner plate of the foreskin, and draw the inner plate incision line parallel to the coronal sulcus about 0.5 cm proximal to the coronal sulcus.

(3) Foreskin removal: Use a sharp knife to cut the skin along the incision lines drawn on the outer and inner plates of the foreskin, and then make a longitudinal incision on the midline of the dorsal side of the foreskin to connect the transverse incisions of the inner and outer plates. Use vascular forceps to lift up the two corners of the leather strip, separate the superficial layer of the blood vessels, and allow the removed foreskin to fall off gradually.

(4) Suturing the incision: After the wound has completely stopped bleeding, align the inner and outer incision edges and perform intermittent sutures using conventional methods. The connective tissue at the incision edge should be sutured together to prevent the skin at the incision edge from curling.

3. Root skin circumcision

(1) Incision line drawing: After pushing the foreskin upward to completely expose the glans penis and confirming that there is no possibility of incarceration, use gentian violet to draw a circular line at the base of the penis to mark the area of ​​skin excision.

(2) Skin circumcision: A circular excision of the penis skin is performed along the surgical line.

(3) Ligation to stop bleeding: Use fine thread to suture the bleeding points on the wound to stop bleeding completely.

(4) Suturing the incision: Use small tweezers to pull the skin on both sides of the incision together and use fine silk thread to suture intermittently.

(5) Bandaging the wound: Apply a layer of sterilized vaseline gauze on the wound and then apply sterile gauze to bandage the wound.