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An improved device for male circumcision: a modified Ross style (Plastibell) tourniquet shielding ring
D. Tomlinson1, L. Shelton2, A. Caldamone3
1Brown University, Department of Family Medicine, Providence, United States, 2Brown University, School of Engineering, Providence, United States, 3Brown University, Department of Pediatric Urology, Providence, United States
Background: Circumcision is one of the few interventions that has shown a beneficial effect on the risk of HIV infection. Ross style circumcision devices (Plastibell) routinely require a dorsal slit in infants and the use of hemostats and scissors. In resource limited areas it would be advantageous to eliminate the need for these instruments and the infrastructure required to sterilize them.
Method: We have modified the circumcision ring originally introduced by Ross (Plastibell). This modified Ross ring is disposable and can be placed within the foreskin without a dorsal slit and incorporates a removable handle that contains a protected blade. Once inserted, the handle must be broken off the shield and inverted to use the protected safety blade to remove the foreskin beyond the tourniquet. Once the handle is broken off, the shield is rendered unusable. This discourages reuse of the shield and ensures a new shield will always be accompanied by a new blade. We evaluated the shield in 83 male infants and tested the blade in another 5.
Results: The shielding ring was successfully placed in all 83 of the infants without making a dorsal slit. In 5 cases, the safety blade was used to excise the foreskin.
Conclusion: We have demonstrated that this simple, disposable, modified Ross style shielding ring can be placed within the foreskin without a dorsal slit and without the need for hemostats and scissors. The safety blade that is incorporated in the handle of the shield offers protection, convenience, and discourages reuse.
[Modified Ross circumcision ring]
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author after the abstract has been accepted for the conference and has not been
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