Background
Circumcision is one of the oldest surgical procedures and is also one of the most commonly performed surgical procedures in practice nowadays. There are several methods and techniques used to perform circumcision. Regardless of which method is used, a complication rate of 0.2–2% is documented. Some authors reported that the use of bipolar diathermy causes less tissue damage, less bleeding, and reduced operative time.
Patients and methods
This is a prospective study about the safety of bipolar electrocautery in circumcision that included 475 infants and children presented to the outpatient clinic seeking for circumcision in the Pediatric Surgery unit, Minia University Pediatric Hospital, during the period between January and December 2021. Patient demographics and data recorded included patient age, type of anesthesia, operative time, duration of bipolar application to the prepuce, intraoperative bleeding, method of skin approximation, and any complications following circumcision.
Results
The age of our patients was 9.92 ± 9.87 months. Overall, 55.79% were operated under local anesthesia, whereas 44.21% were operated upon using general anesthesia. The electocautery application time during circumcision was 44.79 ± 14.69 s. Overall, 45.89% of cases required trimming of the mucosa due to long mucosal cuff. There were no recorded cases of bleeding nor ischemic insult to the glans or the penile skin. Postoperative penile edema was encountered in 81.68% of cases.
Conclusion
Bipolar electrocautery is a safe, easy, and bloodless method in circumcision by the crush technique. The cosmetic results are highly acceptable. Low current mode is highly recommended to decrease the duration of postoperative edema.