Clinician to Clinician: A new light on circumcision

When I was in training in the 1970s, Gomco and Mogen clamps were in use for circumcisions, and pediatricians did these procedures. When I moved to Florida a few years ago, I started performing circumcisions once again. I've come upon a technique that sheds new light on an old procedure that many obstetricians do not like.

I always felt the Gomco clamp was too traumatic and the Plastibell never made sense to me. The Mogen clamp is less traumatic, easy to apply, and the procedure takes just a few minutes. But there is a risk of trapping the glans penis in the clamp. Placing the clamp in the antero-postero plane and angling it to clamp off less of the frenulum-a technique I read about in this magazine-does help.

A year or so after I started placing the Mogen clamp in the antero-postero plane, I happened to use a goose-neck lamp to illuminate the field because my warmer light was weak. The lamp was at the level of the field when I grasped the foreskin and placed traction on it to apply the Mogen clamp. It transilluminated through the foreskin, making it easy for me to see the glans penis. I now insist on having a gooseneck lamp in position for every circumcision because it allows me to apply the clamp without worrying about injuring the glans. The light makes a simple procedure with the Mogen clamp safer and more efficient, increases my comfort level, and ensures good results.