一次性包皮自動切割縫合器:安全有效的兒童包皮環切術方式

陳正宇¹、蘇家震¹、黃冠華¹

¹奇美醫療財團法人永康奇美醫院外科部泌尿外科

Disposable circumcision suture device: a safe and effective method to perform circumcision for children

Cheng-Yu Chen¹、Chia-Cheng Su¹、Steven Kuan-Hua Huang¹

¹Division of Urology,Department of Surgery,Chi Mei Medical Center,Tainan,Taiwan

Background: Disposable circumcision suture device (DCSD) is demonstrated to have the benefit of shorter operative time, shorter wound healing time, less intraoperative blood loss, better cosmetic penile appearance, lower intraoperative and postoperative pain, lower incidence of infection and incision edema in the treatment of redundant prepuce and phimosis. Our aim is to summarize the application experience of disposable circumcision suture device in pediatric patient in our hospital in recent 4 years.

Purpose: To summarize 59 cases experience of disposable circumcision anastomat in pediatric patient in our hospital.

Report of cases: A series of 59 pediatric cases receiving circumcision with disposable circumcision anastomat, recorded during the 2020/06 to 2023/10 period at our hospital, is presented. The patient’s age is 3~12 with diagnosis of phimosis and 14 patient has balanitis. They all received steroid oint or spersin oint treatment for phimosis over 4 weeks with limited improvement. 41 cases received operation under general anesthesia and the other 19 cases was under local anesthesia. The operation time is within 40 minutes(Mean:34.9 minutes±SD17.5). No complication was noted, such as wound dehiscence, bleeding, hematoma, penile skin scars, or wound infection. Preputial edema was limited. Routine pain control with acetaminophen was prescribed for 3 days and no obvious intra-operative and post-operative wound pain was noted. Most patient’s suturing nails shedding within 1~2 weeks, but one of the cases got delay shedding and need surgical removal. All cosmetic penile appearance was smooth.

Discussion and conclusion: In our patients, 18 cases were performed under local anesthesia and other 41 cases were performed under general anesthesia or Intravenous general anesthesia . In local anesthesia group, they still have good tolerance which may related to less operative time and pain with DCSD. Our operation time included performing of anesthesia and preparation and the real time of conducting DCSD was whthin 20 minutes. No special complication was noted, except for mild preputial edema and it improved after suturing nails shedding without medication treatment. One of the case had delayed shedding due to the rubber ring with suturing nails. We cut the rubber ring 1week later after operation and it sheded within 3 weeks. However, we cut the rubber ring at 3,9 and 12 o’clock during operation on the other cases and they sheded within 1~2 weeks. In conclusion, disposable circumcision suture device provides an easy, quick, safe, and effective method to perform circumcision for children and it can be performed under local anesthesia due to less pain and quick operative time.