一次性包皮自動切割縫合器在兒童包皮環切術的初步經驗-7個案例分享

黃詩孟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

Initial experience of apply of disposable circumcision suture device to children-7case sharing

Shih-Meng Huang¹、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) has the benefit of shorter operation time, less blood loss, less pain score,fewer complications,easier manipulation,better cosmetic penile appearance, and higher appearance satisfaction compared with conventional circumcision as previous study.  

Purpose:

To summarize the initial application experience of disposable circumcision anastomat in pediatric patient in our hospital.

Report of cases:

A series of seven pediatric cases receiving circumcision with disposable circumcision anastomat(ZSR Biomedical Technology,ZSR-DCA 10,12,14,16,18,22), recorded during the 2020/06 to 2021/02 period at our hospital, is presented. The patient’s age is 3~12 with diagnosis of phimosis and 2 patient has balanitis. They all received steroid oint or spersin oint treatment for phimosis over 4 weeks with limited improvement.The initial 2 cases received operation under general anesthesia and the others was under local anesthesia. The operation time is within 60 minutes(Mean:50.29 minutes±SD14.02). 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 patients’ suturing nails sheded within 1~2 weeks,but our first case got shedding about 3 weeks later. All cosmetic penile appearance was smooth.

Discussion and conslusion:

Our initial two pediatric cases was performed under general anesthesia due to worrying about pediatric patients’ tolerance and degree of cooperation. However,the later cases were under local anesthesia and they still have good tolerance and cooperation 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. The time of suturing nails shedding of our first case was longer due to the rubber ring with suturing nails. We cut the rubber ring 1 week 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 their suturing nails 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 they can tolerable to the operation well under local anesthesia due to less pain and quick operative time.It can reduce the risks of anesthesia for children.