Minimally Invasive Circumcision
Circumcision has been documented for over 450 years. Currently, common circumcisions include traditional circumcision (dorsal cut circumcision), circumcision sleeve, laser circumcision, and cuff circumcision. Except for the cuff method circumcision all other surgical methods remove the superficial fascia (meatus) of the penis and its superficial blood vessels, and there are abundant lymphatic vessels in the superficial fascia. The operation is prone to impaired blood and lymphatic circulation in the endplate, complicated by endplate lymphedema, long postoperative edema and poor wound healing. It is easy to have postoperative secondary bleeding and hematoma, which affects postoperative recovery and quality of life; and it is not easy to deal with the prepuce tether, which can easily cause too much or too little excision of prepuce tether. Excessive excision can cause the head of the penis to bend down or pain during erection; too little excision can cause bloating in the area, affecting the aesthetics and the quality of sexual life.
Circumcision (Korean circumcision), laser circumcision and other surgical methods require the use of more expensive special equipment, higher surgical costs, surgical results are not better than the traditional scissors method, only in shortening the operating time and reducing the amount of bleeding has the advantage. The laser method is to use the laser as a knife to cut the foreskin, laser cutting is thermal cutting, reducing bleeding while also causing burns on the cutting edge, which is not conducive to post-operative incision healing. After the cutting is completed, the wound still has to be stitched up.
In our male department, we have created the first “electric peeling absorbable thread suture cuff circumcision” based on the classic “cuff circumcision”, which is designed according to the anatomical characteristics of the penile foreskin and is performed outside the superficial fascia and between the skin of the penis. The skin is separated. Only the skin is removed and the flesh membrane is kept intact without damaging the subcutaneous blood vessels and lymphatic network structure of the penis, so postoperative incision bleeding and hematoma formation are minimal. The penis is thickened to varying degrees.
The preoperative incision design avoids blind cutting during the operation, and the excision length is well grasped, and the cut edge of the skin is neat after the operation, preserving the original beauty of the penis. At the same time, because the skin of both sides of the penis is equal in length, the penis will not be bent to one side during erection; for those whose ties are too short, the ties will be lengthened first and then the inner plate will be circumcised. After the operation, there will be no foreign body reaction, painful nodules, painful erection or sexual discomfort in the penis; this procedure uses absorbable sutures with a suture margin of 0.8-1.0mm, which is less stimulating to the incision, less scar formation, and neat and beautiful cutting edge. The suture margin is small, and the suture can be removed automatically by cutting the skin edge or after partial absorption. The pain of suture removal is eliminated.
In this procedure, the inner and outer plates are circumferentially cut, and the intact flesh membrane tissue is preserved, so the operation requires delicate operation, so the circumcision time is longer than the traditional procedure. However, this procedure uses electric knife to peel off, the level is clear, intraoperative bleeding is very small, no need to spend too much time to stop bleeding, no need to rely on suture to stop bleeding, greatly saving the operation time. With the improvement of surgical proficiency, the operation time is also greatly shortened. We do this operation from the beginning of anesthesia to the completion of bandaging in an average of 30 minutes.
Pre-operative preparation
1.Clean genitals: From 3 days before the surgery, wash your genitals with warm water every day. When cleaning, turn the foreskin over to expose the coronal sulcus and thoroughly remove the foreskin scale. However, it should be noted that the foreskin should be reset in time after cleaning to avoid causing penile foreskin imbrication. The night before or on the day of the operation, shave the pubic hair and clean the local area.
2, concurrent foreskin, penile head inflammation, first medication, after the inflammation subsided before surgery.
3, pre-operative blood sampling to check the coagulation function, coagulation function is normal before surgery.
4, eliminate tension: because of the initial days after surgery wound will be some discomfort, some people worry that after surgery will have an impact on sexual function, this idea is unnecessary. Generally speaking, circumcision will not affect the normal sexual function. On the contrary, if the burden of thought is carried, but it may cause mental sexual dysfunction. The surgery is not painful after anesthesia, and there is only slight pain after the surgery. If you are sensitive to pain, you can take painkillers.
5.Surgery is usually performed under local anesthesia, if the doctor does not specifically instruct, you can eat and drink normally.
6. Wear loose cotton underwear and pants for the surgery.
Precautions after surgery
1.Take medication on time and according to doctor’s orders after surgery.
2, keep the dressing clean and dry, avoid urine contamination of the incision (postoperative urination body tilt forward, or bend forward, so that the urethral orifice vertical down, the end of urination with a tissue to wipe the urethral orifice urine, to avoid urine wet dressing), two days after a change of medication, such as urine wet dressing need to come to our hospital or in the nearby regular hospital in time to change medication. 8 days after surgery to our hospital to remove the dressing (child patients such as Vaseline sand strips, no need to remove, will fall off on their own after 2 weeks), remove the dressing external disinfectant, 3-5 times a day, urination, bathing after the timely spray disinfectant.
3, sutures will automatically fall off in about 4 weeks after surgery, if there is redness and oozing at the sutures or more than 4 weeks still not fall off, you can come to the hospital to remove the sutures (do not remove the sutures by yourself).
4.Postoperative rest is not required, you can walk around, but avoid strenuous activities to prevent bleeding after activities. Avoid prolonged standing and sitting to avoid swelling of the penis head and poor healing of the injury due to poor local blood circulation.
5.Loose, breathable, cotton underwear to reduce the friction of the penis.
6, one week after surgery to maintain a calm mood (as little as possible to contact your lover or girlfriend, avoid thinking or contact with pornography, sex magazines, passionate network pictures and videos), avoid sexual impulses, try to avoid erection, in order to avoid incision cracking and bleeding and infection, such as erection, should be deep breathing, relaxation, distraction. Sexual intercourse is prohibited within 30 days after surgery and before the sutures fall off completely.
7.If bleeding, swelling, glans swelling and color abnormalities occur after surgery, you should come to our hospital for follow-up in time.
8.After the operation, you can strengthen the nutrition appropriately and supplement fish, meat and eggs appropriately.
9.No wet incision within 10 days after surgery, after 10 days, if the incision is healed, you can take a shower and spray disinfectant after the shower.
10.If there is obvious prepuce and glans adhesion before the operation, the foreskin and glans will be separated during the operation, and the separated surface will have ooze, erosion and crust after the operation. After the operation, there is a possibility that the glans of foreskin will adhere again, and the foreskin should be turned up regularly.
11. After surgery, some patients may have foreskin covering part of the glans when the penis is not erect, this is normal, when the penis body is elongated during erection, that is, no foreskin covering the glans.