Gomco clamp
A Gomco clamp, otherwise known as a Yellen clamp,[1][2] is a specialized clamp for performing circumcisions. It was invented by Hiram S. Yellen and Aaron Goldstein in 1934-1935.[3][4] Gomco stands for the GOldstein Medical COmpany, the original manufacturer of the clamp.[2] In a 1998 study, it was the preferred circumcision technique of 67% of US physicians.[5]
Method
The technique is as follows:[6]
- Anesthetic should be applied (though it is a historically recent addition, dating only to approximately the early 1990s).
- The foreskin is gripped with two hemostats (needle-nosed pliers) and a blunt object is forced between his foreskin and glans, tearing the connective tissue.[7]
- Once separated, a hemostat is used to crush his foreskin lengthwise in order to reduce bleeding..[8]
- Next, the foreskin is sliced lengthwise through the crushed tissue (dorsal slit) to allow space to insert the circumcision device..[9]
- The bell of the Gomco clamp is placed over the glans, and the foreskin is pulled over the bell.
- The base of the Gomco clamp is placed over the bell, and the Gomco clamp's arm is fitted.
- After the surgeon confirms correct fitting and placement (and the amount of foreskin to be excised), the nut on the Gomco clamp is tightened, causing the clamping of nerves and blood flow to the foreskin.
- The Gomco clamp is left in place for about five minutes to allow clotting to occur, then the foreskin is severed using a scalpel.
- The Gomco's base and bell are then removed, allowing for bandaging of the penis
Advantages
- The scar is straight.
- The circumcision is relatively quick compared to the more recent Plastibell.
Disadvantages
- Involves several small parts which all must be sterile for the safety of the patient.
- Procedure takes longer than the traditional Jewish Shield or Mogen Clamp techniques.
- The scar is more visible.
Prevalence
Probably over 75% of circumcised American men born between 1950 and 1980 were circumcised with a Gomco clamp or a variant. The presence of a light brown ring, typically one inch behind the corona, probably indicates a Gomco circumcision.
Notes and references
- ^ Warner E, Strashin E (November 1981). "Benefits and risks of circumcision". Can Med Assoc J 125 (9): 967–76, 992. PMC 1862490. PMID 7037142. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1862490.
- ^ a b Gelbaum I (1993). "Circumcision. Refining a traditional surgical technique". J Nurse Midwifery 38 (2 Suppl): 18S–30S. doi:10.1016/0091-2182(93)90093-V. PMID 8387102.
- ^ Hodges, Frederick (1997). "A Short History of the Institutionalization of Involuntary Sexual Mutilation in the United States". In Denniston, George C.; Milos, Marilyn Fayre. Sexual mutilations: a human tragedy. Springer. pp. 26. ISBN 9780306455896.
- ^ Alanis MC, Lucidi RS (May 2004). "Neonatal circumcision: a review of the world's oldest and most controversial operation". Obstet Gynecol Surv 59 (5): 379–95. doi:10.1097/00006254-200405000-00026. PMID 15097799.
- ^ Stang HJ, Snellman LW (June 1998). "Circumcision practice patterns in the United States". Pediatrics 101 (6): E5. doi:10.1542/peds.101.6.e5. PMID 9606247. http://pediatrics.aappublications.org/cgi/content/full/101/6/e5.
- ^ Peleg D, Steiner A (September 1998). "The Gomco circumcision: common problems and solutions". Am Fam Physician 58 (4): 891–8. PMID 9767725. http://www.aafp.org/afp/980915ap/peleg.html.
- ^ HealthWise Medical Reference, Available online at: http://children.webmd.com/tc/circumcision-what-happens-during-a-circumcision Last Updated: February 19, 2008.
- ^ HealthWise Medical Reference, Available online at: http://children.webmd.com/tc/circumcision-what-happens-during-a-circumcision Last Updated: February 19, 2008.
- ^ HealthWise Medical Reference, Available online at: http://children.webmd.com/tc/circumcision-what-happens-during-a-circumcision Last Updated: February 19, 2008.
External links