Circumcision

Circumcision 

 Circumcision 

 Hypodermal and ⑴ roots on both sides of the penis penis anesthesia 

 ⑵ corpus spongiosum anesthesia 

 

 

 

 (3) The clamp used to stop bleeding from the dorsal prepuce 

 (4) has slot probe stripping foreskin adhesions 

 (5) along the probe slot cut foreskin 

 (6) from circumcision foreskin冠状沟0.5cm 

 (7) Department with the Agency should retain the foreskin 

 (8) dorsal penile vein ligation hemostasis 

 (9) and outside the plate suture 

 (10) using suture fixation Vaseline gauze 

 

 [Indications] 

 1. Phimosis sick child because of packet stenosis obstructs bladder voiding or repeated infection. 

 2. Adult patients suffering from phimosis phimosis or recurrent infection. 

 Childhood phimosis is normal, the infant or child has phimosis have phimosis, in the absence of complications, circumcision should not be implemented. 3 years of age because of phimosis in children with the age of the growth of many disappear on their own; another part of the child will be repeated as long as the foreskin back up and expanding package bladder mouth, it will expose the penis head, do not have surgical resection. 

 [Preoperative preparation] 

 1. The night before surgery and the surgery that day, told local Patient cleansing. 

 2. Concurrency foreskin, penis head inflammation, the need to choose drugs and partial immersion treatment, the inflammation subsided after surgery. 

 [Narcotic] 

 Local anesthesia or anesthesia corpus cavernosum; pediatric anesthesia may be basic. 

 [Surgical procedures] 

 1. Posture supine position. 

 2. Disinfection cleaning with soapy water and brine partial, using 1:1000 Bromogeramine liquid disinfectant; phimosis venous access in order to cut the syringe needle to inject liquid Bromogeramine foreskin intracapsular disinfection. 

 3. Separation of adhesions and stenosis have foreskin and penis head foreskin adhesions, the first expansion of the foreskin clamp the mouth, and then two bleeding from the dorsal margin of the middle clamp parts (two clamp apart 0.2cm). With probe separation of adhesions have slot until the penis head and foreskin completely separate. Clean with normal saline and then sterilized package bladder and penis head. 

 4. Incision design to live with a hemostatic clamp foreskin tether in order to bring the foreskin. To tip in the foreskin away from the outer plate distal margin of 0.5cm Department auriculoventricular furrow zoned all the marks, be absolutely sure I prepare as a ring, to prevent excessive resection. 

 5. Dorsal incision with scissors cut along the probe slot foreskin inside and outside the plate, the foreskin should be cut within the plate to about 0.5cm from the edge of auriculoventricular furrow Department. 

 6. Resection of the foreskin to foreskin inside and outside the plate alignment, outward opening folders in the dorsal prepuce and tether clamp Department, and then review board foreskin cutting marks outside the ring as a small voice I is appropriate. If appropriate, use of curved scissors along the auriculoventricular furrow about 0.5cm from the cut marks Department cut the right side of flap [Figure 2 ⑷], and then cut the left side. Foreskin inside and outside the Department with the Agency's board can not cut, or retain some many. 

 7. Hemostasis penis skin back up, showing bleeding point bleeding, should pay particular attention to the middle of the dorsal penile dorsal vein ligation. 

 8. Sutured with fine silk thread first annular notch in the back, abdomen, left and right 1 Department suture needles, not too tight ligation to prevent tissue edema when Le bad skin. Suture is not cut, has been reserved for a fixed dressing used. And then every two suture needle suture between 1 ~ 2 needle, needle piercing should be near the margin. 

 9. Dressings will be a Vaseline gauze (overlapping edges on the inside) the incision around the foreskin, with suture fixation to stay long, and then use several layers of gauze bandage. 

 [Intraoperative Notes] 

 1. Circumcision, the inside and outside the cubicles of the blood vessels to the proximal stump often retreat, must be found to be ligated, or can form large hematoma. 

 2. Prepuce can not cut too much, so as to avoid painful penile erection. General foreskin inner plate should be cut to about 0.5cm from the Department auriculoventricular furrow. Department of the Ministry can not be left with too little. 

 [After treatment] 

 1. 3 ~ 4 days after bedtime clothes in sedation, analgesia, preventive medications to prevent penile erection, causing pain and bleeding. 

 2. Inform the patient not to urinate when wet gauze.