# Bedside Removal of a Retained Plastibell Ring Using Handheld Electrocautery in the Emergency Department

## TL;DR

A 15-day-old baby had a Plastibell ring removed using handheld electrocautery at the bedside when other methods failed, showing it could be a viable alternative.

## Contribution

Introduces handheld electrocautery as a feasible alternative for removing a retained Plastibell ring in resource-limited settings.

## Key findings

- The plastic ring was successfully melted and removed using electrocautery without sedation or injury.
- Post-removal examination showed normal perfusion and no urethral damage.
- Follow-up at five months showed normal healing and cosmesis.

## Abstract

We report a 15-day-old infant with a proximally migrated Plastibell and marked glans edema. Ligature release with gentle manipulation was unsuccessful; scissor division was judged unsafe, and a ring cutter was unavailable. A handheld, battery-powered fine-tip cautery was used at the bedside to melt and divide the plastic ring with tissue protection and local analgesia, permitting removal without sedation. Postremoval examination showed preserved perfusion without urethral injury, and five-month follow-up demonstrated normal healing and cosmesis. This case suggests that handheld cautery may be a feasible and resource-conscious alternative when mechanical methods are unsuitable or unavailable. Careful patient selection and thermal safety measures are essential, and further experience is needed to define their role.