Sirkumsisi

Teknik Sirkumsisi
Dorsal Slit
Quillotine
Sleeve

Metode Quillotine
Memotong preputium secara langsung pada
preputium yang dibatasi oleh forcep
(amputasi)
Keuntungan
Dapat dilakukan di klinik
Menggunakan alat yang lebih sedikit

Kerugian
Risiko cedera pada glans penis besar
Meninggalkan sisa mukosa sekitar 0,5 1 cm di
corona glandis

SURGICAL TECHNIQUE
Step 1. Prepare skin, drape and
administer anaesthesia.
Step 2. Retract the foreskin and
separate any adhesions.
Step 3. Mark the intended line of the
incision.

Step 4. Grasp the foreskin at the 3

oclock and 9 oclock positions with
Step 5. Put sufficient tension on the
foreskin to pull the previously

Step 6. Using a scalpel, cut away the foreskin

flush with the outer aspect of the forceps. The
forceps protects the glans from injury, but
nevertheless, particular care is needed at this
stage.
Step 7. Pull back the skin to expose the raw area.
Clip any bleeding vessels with artery forceps

Step 8. Place a horizontal mattress

suture at the frenulum.
Step 9. Place a vertical mattress suture
opposite the frenulum, in the 12
oclock position

Step 10. After placement of the sutures at the 6,

12, 3 and 9 oclock positions, place two or more
simple sutures in the gaps between them.
Step 11. Once the procedure is finished, check for
bleeding. If there is none, apply a dressing

Metode Dorsal Slit

Memotong preputium pada pukul 12 sampai ke
korona glandis kemudian preputium dipotong
secara sirkuler
Keuntungan:
Dapat dikerjakan di klinik
Membutuhkan alat yang standar
Risiko glans penis terluka kecil
Panjang mukosa yang dipotong dapat ditentukan
Dapat digunakan pada pasien dengan phymosis atau
parahymosis

Kerugian
Risiko perdarahan besar tanpa menggunakan cauter
Estetika hasil sirkumsisi tergantung keahlian operator

Step 1. Prepare skin, drape and administer

anaesthesia
Step 2. Retract the foreskin and remove any
adhesions
Step 3. Mark the intended line of the incision
Step 4 (optional). Some surgeons prefer to mark
the line of incision by making a very shallow
incision using a scalpel.
Step 5. Grasp the foreskin with artery forceps at
the 3 oclock and 9 oclock positions

Step 6. Place two artery forceps on the foreskin

in the 11 oclock and 1 oclock positions
Step 7. Between the two artery forceps, in the
12 oclock position, use dissection scissors to
make a cut (the dorsal slit) up to but not
beyond the previously marked incision line
Step 8. Using dissection scissors, cut the
foreskin free, following the previously marked
circumcision

Step 9. Any skin tags on the inner edge of

the foreskin can be trimmed to leave
approximately 5 mm of skin proximal to
the corona
Step 10. Stop any bleeding and suture, as
described in steps 710 of the forcepsguided method.
Step 11. Check for bleeding. If there is
none, apply a dressing

Metode Sleeve
Memotong preputium pada daerah yang
ditandai terlebih dahulu.
Kelebihan :
Lebih baik bentuknya
Risiko cedera kecil

Kekurangan :
Memerlukan asisten
Cukup sulit
Tergantung keahlian operator

Step 1. Prepare skin, drape and administer anaesthesia

Step 2. Retract the foreskin and remove any adhesions
Step 3. Mark the intended outer line of the incision
Step 4. Retract the foreskin and mark the inner
(mucosal) incision line,12 mm proximal to the corona.
At the frenulum, the incision line crosses horizontally

Step 5. Using a scalpel, make incisions along the

marked lines, taking care to cut through the skin to
the subcutaneous tissue but not deeper
Step 6. Cut the skin between the proximal and distal
incisions with scissors
Step 7. Hold the sleeve of foreskin under tension
with two artery forceps, and dissect the skin from
the shaft of the penis, using dissection scissors

Step 8. Stop any bleeding and suture,

as described in steps 7 10 of the
forceps-guided method.
Step 9. Once the wound has been
sutured, check for bleeding. If there
is none, apply a dressing