Smartklamp part 2

2. circumcision with smartklamp

'Ring Block' technique is commonly used in older child.
Injection of about 1-2cc LA given through subdermal space
at 11 ' and 1 ' o'clock position at base of penis. Then the LA
is injected laterally and toward the ventral surface of penis.
Injection through ventral site is also commonly practiced.

The foreskin needed to be stretched wide to allow the tube
to be inserted. Apply some lubricants like petroleum jelly over
the tube so the insertion is less friction.

Once the tube is secured inside the foreskin, release the
forceps. If necessary catch and pull the edge of foreskin with
forceps.

Outer clamp then inserted. It needed to be angled about 30
degree before passing through the rectangular part of the
inner tube. The clamp is inserted over the tube and pushed
as far as possible until it reaches the end of the cylinder
tube. This is where the skin is tightly gripped between the
tube and the clamp.

The clamp then is turned 90 degree clockwise or
anticlockwise to allow the rectangular part of the tube fixed
onto the clamp outer rectangular ring. When enough foreskins
have been pulled and urethral meatus is properly aligned in
the center, press the lock once.

When the side arms pressed in further, the second lock
activated and the smartklamp is fully locked. If there are
complications, the lock can still be released, but a bit harder.

At day 5 of post circumcision, use a cutter to cut through
the outer ring of the external clamp. Smartklamp is easily
removed with minimal pain.