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abstract

abstract

126

Initial experience with the rapideclamp device in adult circumcision. Step-by-step surgical video

Garcia-Baquero, R1; Fernandez Avila, CM1; Parra Servan, P1; Ojeda Claro, AV1; Flor Peña, A1; Aguera Bitaube, J1; Rosety Rodriguez, J1; Leon Delgado, C1; Ledo Cepero, MJ1; Soto Villalba, J1; Soto Delgado, M1; Madurga Patuel, B1; Alvarez-Ossorio Fernandez, JL1

1: Hospital Universitario Puerta del Mar, Cadiz, Spain

Objetive. Circumcision is one of the surgical procedures with more historical tradition. In our clinical practice, the indication of circumcision is mainly medical, with a high and persistent surgical demand. It would be interesting to find a new surgical technique that reduces surgical time, cost and complications, maintaining a good final aesthetic result, compared to the classical technique.

Material and methods. We performed a descriptive analysis of our initial experience with 5 adult patients undergoing circumcision with the RapideClamp ring device (Neomedic International), collecting data such as surgical time, complications and pain during the first month of follow-up, documenting progressive healing and the final aesthetic result with images. We expose all the data by video presentation to add a detailed explanation of the technique step by step.

Results. Initially the device was tried to be placed in 9 patients, of which there are 4 failed attempts because glans size was superior to the diameter of the ring and to the intraoperative sliding of the ring after the exeresis of the foreskin. In relation to the 5 in which the device was used, there were no major complications except for one case of ring mobilization in the first 24h that required suturing. The average surgical time was 13 minutes and 6 seconds. Pain was moderate in the first 4 hours (Visual Analog Scale - VAS 5) and during erections (VAS 5-6), and mild in the first 48 hours and after 5 days (VAS 3-4). The pain was moderate-high during device removal (VAS 6-7), mild at 15 days (VAS 2) and very mild at 1 month (VAS 1). In all cases, the healing was favorable, as well as the final aesthetic result (images attached).

Conclusions. The RapideClamp ring is a novel device in our institutions, which we don't have prior training, and it requires a minimal learning curve and more experience for optimal use and its final evaluation. The initial experience is positive, with a clear reduction in surgical time, not requiring suturing, and a good aesthetic result after one month of surgery. We believe that it would be interesting to carry out cost-effectiveness studies with the classical technique.

Disclosure:

Work supported by industry: yes, by Neomedic International (no industry support in study design or execution).

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