Useful tips and tricks for secure circumcision

Introduction: The study aimed to find a secure procedure for circumcision, using monopolar diathermy with several key steps of technique to facilitate the surgical process and minimize the postoperative complications. Methods: Patients who underwent the secure technique for circumcision, due to different reasons, from 2012 to 2016 were retrospectively reviewed. A monopolar coagulator with a needle point probe with energy ranging from 10 to 15 W was used to perform the circumcision by following several key steps. In addition, tissue glue was applied to the wound to provide operative wound care. All data referring to patient demographics were recorded. The outcomes and complications associated with the secure technique for circumcision were assessed. Discussion: One hundred and ten children underwent this technique, carried out by a senior teaching staff member and several senior residents. All patients were followed with a mean of 29.5 ± 30.1 days postoperatively. All these patients were satisfied with the operation and had no major complications, and no second revisions were needed during the follow-up period. Two patients (1.8%) had a minor wound infection, which was resolved with oral antibiotics within 1 week. However, the study limitations included its retrospective nature and the heterogeneity of the study population. Conclusion: Modified diathermy circumcision with the secure technique protects the penile phallus and urethra, and it is associated with a low rate of complications, as hemostasis can be simultaneously ensured. The technique is feasible, simple, and easy to learn. In addition, tissue glue was proved to facilitate postoperative wound care.