Circumcision is best described as a minor surgical procedure in which the foreskin or the fold of skin covering the penis is removed aseptically. This is commonly practiced in the U.S., Australia, Canada, West Africa, Middle East, and Central Asia.

Circumcision is typically performed on a newly born male on the eighth day of his existence. However, the procedure can be done on older children – even on adults. The circumcision procedure can be done by a trained pediatrician, urologist, surgeon, or mohel.

There are various reasons parents decide to have their sons circumcised, such as to improve hygiene, decrease the risk of urinary tract infection, and reduce the risk of contracting sexually transmitted diseases. However, it is essential to note that circumcision is not medically required, although the benefits of such a procedure significantly outweigh the risks. 

After 40 years of thorough medical investigation, the American Academy of Pediatrics (AAP) has concluded that circumcision may not be necessary for a newborn child. According to them, the procedure is not beneficial to a child’s overall health and well-being and may not be medically recommended. 

 

Why Do We Perform Circumcisions?

While there are many medical controversies about circumcision, many families still celebrate this covenant since this has been an integral part of their religion. Religion is considered the top reason why every boy in some parts of the world gets circumcised before leaving the birthing facility. In Islam and Judaism, the procedure is a sacred ritual that is stipulated in their religious laws. Thus, circumcision is more commonly known as khitan in the Islamic culture, while it is termed brit or Bris Milah in Judaism. The Jewish community views the circumcision procedure as an initiation rite for newborn males.

In general, circumcision can be performed in many different ways, but the three most commonly used methods are the Gomco clamp, Plastibell device, and Mogen clamp. For more information about these three main circumcision types, continue reading below. 

 

The Three Main Circumcision Types

The three most commonly used methods of circumcision are the Gomco clamp, Plastibell device, and Mogen clamp. These methods technically work by impeding blood flow to the skin fold once the circumciser cuts off the foreskin.

Before the procedure, the child will be laid flat on the bed with both arms on the side. Then, the circumciser will administer local anesthesia via sterile injection or anesthetic cream to numb the penis. The entire circumcision procedure takes about 20 to 30 minutes to finish. The three methods also produce different circumcision cut types. 

 

Circumcision Using the Gomco Clamp

The Gomco clamp is a sterile surgical device specially designed to perfect and control the cutting of the foreskin during the circumcision procedure. The clamp is composed of a round metal cap, metal plate, and screw device. 

The Gomco circumcision method is simple, fast, and effective. In addition, the procedure only produces minimal to moderate bleeding that can be managed using pain medications. However, some medical professionals have raised concerns regarding the procedure, such as poor usage of aseptic techniques and poor cosmetic quality. Despite these concerns, Gomco circumcision is still widely performed worldwide. 

Before the procedure, informed consent is secured, and the patient is given local anesthesia. The penis is exposed and cleaned aseptically. The doctor or circumciser will then stretch the preputial opening and retract the foreskin to expose the glans penis. A lubricant will be applied to the glans penis to prevent it from sticking inside the bell. The next step is to place the cap over the glans penis and pull the prepuce over the bell. The skin fold should not be stretched or pulled too tightly. Pulling the prepuce too tightly could result in urethral trauma

After making sure of the dimensions, the clamp plate will be placed over the foreskin. Then, the flange on the clamp’s handle will be fitted and tightened. This will eventually squeeze the prepuce between the clamp and the bell. The squeezing makes the procedure painless and blood-free. The foreskin is then cut off with a scalpel or surgical scissors. 

The clamp is gently removed using an antiseptic, and a clean dressing is applied. Early clamp removal will result in profuse bleeding, which will prompt the circumciser to perform suturing. After the procedure, the parents should watch out for any signs of bleeding at home.

 

Circumcision Using the Plastibell Device

Plastibell circumcision is another simple, quick, and effective circumcision technique. The Plastibell can be described as a small plastic ring with a handle placed between the prepuce and the glans penis. 

Here are the procedures to follow in a Plastibell circumcision:

  • Place the child on a flat surface or surgical bed with both arms and legs restrained.
  • Apply topical anesthesia or administer Lidocaine (local anesthesia) injection.
  • Separate the foreskin or the prepuce from the glans penis using a probe or a slender surgical rod. 
  • Insert a Plastibell or plastic ring underneath the foreskin of the baby.
  • Stretch the foreskin over the Plastibell and secure a suture or sterile string to allow clotting or coagulation to occur. 

 

Circumcision Using the Mogen Clamp

This popular circumcision method is typically used in Bris Milah ceremonies. Nowadays, many U.S. doctors are using this method due to its simplicity and effectiveness. The entire procedure is bloodless and straightforward. In addition, postoperative infection is less likely to happen since the instrument is not left on the baby’s penis. 

The Mogen clamp is a specialized surgical instrument for circumcision that can be used for both neonatal boys and older kids. It has two sharp, flat blades that are approximately 2.5-3.0 mm in size. 

The first step in the Mogen clamp technique is securing consent. Then, the circumciser will place the baby on a flat surface. Next, local anesthesia is delivered via injection or cream. Finally, the circumciser will extend the foreskin using straight hemostats to expose the glans penis and safely place the Mogen clamp.

The circumciser will slide the clamp across the prepuce from the back to the front. This step needs to be performed correctly and carefully. After ensuring that the tip of the glans penis is exposed, the circumciser will then lock the Mogen clamp. Next, he will cut the fold of skin from the upper portion of the clamp using a surgical scalpel. Typically, no sutures are needed for newborn babies. However, in older adults, suturing or applying a cyanoacrylate tissue adhesive is needed. 

 

Choosing Rabbi Rappaport for a Perfect Circumcision Experience

Rabbi Rappaport is a certified, specialized mohel offering the perfect Bris Milah experience in the MD/DC/VA area. His works and credentials can give your child the ultimate ritual circumcision he deserves. In addition, he is more than willing to offer his perfect services not just for the Jewish community but also for the Non-Jewish and inter-faith families. 

With more than 20 years of professional experience, he can guarantee that your son will experience an optimal initiation rite. Make this an enjoyable experience – one that is full of meaning, joy, and happiness!

While many doctors or practitioners in the hospital will use the Gomco or Plastibell, Rabbi Rappaport will only use the Mogen clamp type of metal. Additionally, whereas in the hospital or doctor’s office type of setting, the procedure can take 10-20 minutes, Rabbi Rappaport guarantees his procedure will take 30-40 seconds. His method is the quickest, most painless, and precise method, thus supporting his pledge of a perfect experience!

If you are planning to organize a ritual circumcision for your child, let Rabbi Rappaport do the job. Contact him anytime on his personal cell at: 443-790-6541. You can also send him an email at rabbi@mdmohel.com or visit his website. He will be happy to help!