A Comparison of Three Techniques in Neonatal Circumcision: Artery Forceps, Bone-cutter, and Gomco Clamp Methods

TL;DR

This study compares three methods for neonatal circumcision and finds the bone-cutter method to be the fastest, safest, and best for cosmetic outcomes.

Contribution

The study provides a direct comparison of three surgical techniques for neonatal circumcision, focusing on safety, speed, and outcomes.

Findings

The bone-cutter method was the fastest and had the least bleeding.

The Gomco method was the slowest and had the worst cosmetic outcomes.

The artery-forceps method had the highest rates of primary and reactionary bleeding.

Abstract

Neonatal circumcision is the oldest and most common surgical procedure The safety, ease, and outcomes of various methods of surgical procedures for neonatal circumcision have become increasingly the focus in the reviews of this procedure. This study aimed to identify the easy, safe and acceptable method for neonatal circumcision.

This prospective study involved 357 male neonates, divided into three groups based on the methods used for neonatal circumcision: artery-forceps, bone-cutter, and Gomco methods. Clamps were uniformly applied for 7 minutes (420 seconds). The study assessed procedure time, primary and reactionary bleeding, and outcomes using the adapted Paediatric Penile Perception (PPP) score. Data were analyzed using SPSS version 23, with a p-value set at <0.05.

Each group consisted of 119 neonates. The bone-cutter method was the fastest (590.2 ± 60.14 seconds), while the Gomco method was the slowest (624.2 ± 55.16 seconds, p<0.001). Primary bleeding occurred most frequently with the artery-forceps method (37 out of 119), and least with the bone-cutter (p<0.001). Only the artery-forceps group had reactionary bleeding (p=0.018). The bone-cutter and Gomco methods had the highest PPP mean scores: 11.91 ± 0.390 and 11.87 ± 0.566, respectively (p<0.001).

The bone-cutter method is the fastest, safest, and produces the best cosmetic outcomes of the three methods studied.

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