While starting the process of circumcision withyou are requested to draw a line over the bubble on the prepuce of glans penis with an acetate pen. This is also recommended with the aim to prevent the spoiling of the circumcision operator’s orientation in the cases where the locally applied anesthetic medicine is risen up to the prepuce.
It is always advised that the dotted lines are drawn in order to designate the middle line from upper and lower parts of the penis.
The process of cleaning and sterlizing the surgical area is performed according to classical surgical procedures after completion of the line drawing process.
The circumcision operator applies the local anesthesia process to the penis after he has finished the cleaning and covering process. Optionallly it is advised to use 5cc syringe and insulin or dental syringe tip. It may be done in the form of Local Anesthesia Dorsal penile block or of Ring block.
After it has been waited for a while, the Local anesthesia controllin process is done. Following the realization of anesthesia, the prepuce is pulled back. By cleaning the penis head completely, any adhesion and simegma are prevented.
It should be paid attention to the fully opening of any adhersions in the coronal area in particular. The area is cleaned and dried with an antiseptical solution once again.
In the cases where the prepisium is narrow (phimosis), it is recommended to carry out the expanding process to the prepisium by a flat forceps. The fırceps is opened in line with the glans and pulled back without closing. This process can, when and if desired, be applied for attaching the tube easily in all cases.
A suitable long tube is placed over the penis head. Since the inclination of the tube is the same with that of the glans penis, the tube will be put over the glans penis like a hat.
The puled back prepuce is brought to its old condition over the transparent tube. In the meantime, for not causing to be any wrinkledness in the internal mucosa, the prepisium is pulled toward outside throughly.
It should be controlled by looking to inside from the tube’s upper hole, whether or not there is mucosal folding; and that the glans is in the neutral position.
