Gomco circumcision: When is it safe?

Horowitz, Mark; Gershbein, Abbey B.

doi:10.1053/jpsu.2001.24739

Cited by 52 publications

(39 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The Gomco clamp circumcision beyond neonatal period has remained undefined. Horowitz and Gershbein [8] in 2001 did not recommend the use of Gomco clamp in patients older than 6 months; however, we are applying the Gomco clamp of appropriate size in older children also under same protocol as in neonates with suturing of the skin edges and applying crushing force to prepuce for 8 to 10 min.…”

Section: Discussionmentioning

confidence: 99%

“…[8] Various techniques of doing this procedure have been described with complication rate ranging from 0.2% to 5%, with the higher complications often related to general anesthesia, difference in method used as well as the experience of surgeon. [1,9] Medical reasons for Dermabond (2-octyl cyanoacrylate) has been used as an adhesive for skin closure after Gomco clamp and sleeve techniques.…”

Section: Discussionmentioning

confidence: 99%

“…In one series of 98 patients, no complication was seen in patients of 1 month of age and younger. [8] Conversely, the complication rate increased substantially when Gomco clamp was used at 3 months of age.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Bloodless, sutureless circumcision

Bhat

Hamid

Rashid

2013

Afr J Paediatr Surg

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bloodless, sutureless circumcision

Bhat

Hamid

Rashid

2013

Afr J Paediatr Surg

View full text Add to dashboard Cite

show abstract

“…Factors predicting complication rate Timing of surgery can be predictive of complications as bleeding related complications are higher in older infants [212]. Penile adhesions and secondary buried penis is more likely in infants with a higher weight for length percentile [213].…”

Section: Cuaj -Guideline Dave Et Al Guideline: Foreskin Care and Neonmentioning

confidence: 99%

CUA guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants

Davé

Afshar

Braga

et al. 2017

CUAJ

View full text Add to dashboard Cite

“…In children over the age of 3 months, the use of these devices is associated with a higher risk of bleeding [1]. Consequently, a sleeve circumcision is the preferred surgical technique.…”

Section: Surgical Techniquementioning

confidence: 99%

Congenital Penile Abnormalities

Bush

Snodgrass

2013

Atlas of Male Genitourethral Surgery

View full text Add to dashboard Cite

25ventrally by the surgeon or anesthesiologist using 0.25% bupivacaine or ropivacaine without epinephrine, as demonstrated in Figure 4.1. Injection ventrally in the scrotal midline provides pain control at the frenulum which is supplied by a branch of the perineal nerve (Figure 4.2) [2]. We prefer a penile rather than a caudal block for most penile surgery as it has been associated with equivalent pain control with a faster time to incision and quicker discharge home [3].The foreskin is manually reduced (Figure 4.3), or, when necessary, a dorsal slit (Figure 4.4) followed by manual reduction is performed. Once the foreskin has been reduced, an incision line is marked circumferentially approximately 5 mm below the glans penis to create a mucosal collar (Figure 4.5). A second circumferential line is marked around the penile shaft skin at the corresponding level. The incisions are then performed circumferentially at these two sites; we prefer a Beaver blade knife holder with a 69 blade. The skin and the dartos layer between the two incisions are excised sharply. Once hemostasis is achieved, the skin edges are reapproximated using a running subcuticular 7-0 polyglactin on a TG 140-8 needle in prepubertal boys, and 5-0 polyglactin in postpubertal boys. We avoid the use of chromic suture through the epithelium due to the risk of creating suture tracks in these patients. Alternatively, reapproximation of the skin edges using 2-octyl cyanoacrylate instead of suture in pre-pubertal patients has been reported and may be less expensive due to shorter operating room time [4]. Surgical complications1 Bleeding. Meticulous hemostasis at the time of surgery should reduce the need for re-exploration. However, CircumcisionAlthough the historic origins of circumcision are unclear, the practice has been carried out for either cultural or religious reasons throughout the world for centuries. The word circumcision originates from Latin: circum meaning around and caedere meaning to cut. The goal of the procedure is to remove sufficient preputial skin to leave the glans exposed. Clinical featuresAlthough the majority of pediatric circumcisions are performed for cultural or religious reasons (Islam, Judaism), the presence of a pathologic phimosis secondary to lichen sclerosus et atrophicus is an absolute indication for circumcision. However, an understanding of the natural history of the foreskin allows clinicians to differentiate a "physiologic phimosis," whereby gentle retraction shows the inner preputial layer coming into view, from a true pathologic phimosis.At birth only 4% of boys have a fully retractile foreskin. By the age of 3 years approximately 10% of boys continue to have a physiologic phimosis. However, by the age of 16 years only 1% have a nonretractile foreskin. Surgical techniqueMethods for circumcision in the newborn infant using the Gomco, Plastibell or Mogan devices have been well described. In children over the age of 3 months, the use of these devices is associated with a higher risk of bleeding [1]. Consequently, ...

show abstract

Gomco circumcision: When is it safe?

Cited by 52 publications

References 5 publications

Bloodless, sutureless circumcision

Bloodless, sutureless circumcision

CUA guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants

Congenital Penile Abnormalities

Contact Info

Product

Resources

About