How Does The Technique Of Circumcision Actually Work?

Factual Questions
1

I am a 33 year old circumcised male with training in the biological sciences that can’t figure out how the operation is actually done.

In my obviously flawed way of thinking, you have a cylinder (the penis) wrapped in excess skin that can move and cover the head. If you cut the excess skin all the way around, you would separate all the skin into two parts and expose the interior creating a bad situation.

What am I envisioning wrong?

***This is not a debate about the merits and morality of circumcision said three times over. It is about how it works.

2

The skin is cut/lopped as if it where crimped.
The edge will bleed then heal over.
Where did you get the idea the foreskin is made of two pieces?

3

Not the foreskin itself although I don’t know much about it at all. If I were to take a boxcutter and go all the way around my penis, two halves would separate (and I would probably pass out). I always though of the foreskin as just being more of that same skin like a Pug’s face. I didn’t (don’t) understand how you can cut all the way around something and have it stay together in a non-stitches and safe way.

4

I’m not seeing the two halves scenario.
You have a ureathra (sp) running through erectile tissue.
Run a box cutter around it and it won’t fall in two pieces but it will bleed profusely.

As an uncircumsized male I can tell you the foreskin has a hooking point where the excess skin and the shaft of the penis join.
This maybe where the confusion is kicking in.

If I roll the foreskin all the way back I reach the point where it joins the main tube.
For all intents and purposes this flared skin is removed during a circumcision so the tube proper is the only skin to remain behind the ‘bell end’

5

You have a turtleneck sweater. You want to turn it into a crewneck sweater. That simple.

6

I used to do circumcisions on newborns. I was an early adaptor of using a local anesthetic to do the procedure. I did circumcisions if requested by the parents, and only after giving them the risk vs. benefit spiel (as it was understood in the 1980’s).

Imagine a cone with an open tip.

Then imagine a long clamp (like a hemostat) being threaded down thru the tip, to the base of the cone. It is NOT going into the urethra, or pinching the glans penis.

This is then clamped tight, crushing the tissue. It is held in place for a minute, then removed.

A scissors is then used to cut along the middle of the crushed tissue, to the base (which is at the base of the glans penis, generally).

A blunt probe is then used to gently tease away the foreskin from the glans penis, and open up the cut cone of the foreskin.

A bell-like plastic cap with a groove running around the lower end of the bell was then placed over the glans penis, with the foreskin on the outside of the bell.

A ligature was tied tightly around the base of the bell, in the groove. This crushed the forskin tissue tightly against the bell, and then the remainder of the foreskin attached to the penis was then cut away, just above this ligature.

This was left in place for a time , then removed and the glans treated with ointment and a sort of styptic gauze which would cauterize any residual bleeding.

Some bells were designed to be left on until they sloughed off.

The procedure took about 10 or 15 minutes, and if properly anesthetized, didn’t bother the little guy much.

Here’s a link with step by step drawings. It doesn’t exactly show what I describe above, but it’s close enough to give a decent idea. Not really worksafe, so I’ll break the link. NOT gross. http://www.pennhealth.com/health_info/Surgery/circumcision_1.html

No, I didn’t keep the tips.

7

Ok, that helped a lot. If anyone wants to know why I was confused, I always thought the there was excess skin through the entire length and you had to pick a point to cut the excess out. Penises that are non-native to my body have never been one of my specialties so I truly didn’t know how that worked at all.

8

The skin is stitched. If you want to know in detail how it’s done, you can follow the first link at Wikipedia’s circumcision entry.

9

**QtM, **thank you for the link and the description.

10

Only in older patients. In newborns, sutures are not necessary. Healing is as good or better without them, due to small size of the incisions, and the incredibly plastic nature of newborn tissue to heal up quite nicely.

11

Damn, and I always just assumed that they used a cigar cutter type of device. Guess I’ll stop telling that joke at the Havanna House.

12

Damn, QtM, that sounds more complicated than I imagined (we weren’t present for either of our son’s circumcisions- we are goyim and had no idea we should invite people over and serve food! :wink: ).

13

I welcome the images of feltching and squicking over your boxcutter analogy.

14

It is made of two pieces, at least, two layers - the skin goes down to the end of the foreskin, then turns back inside itself and back in to join to the base of the glans, so when flaccid, the foreskin is two layers of skin, like a sock puppet’s mouth.

15

I wonder if Calamari would be appropriate to serve at a circumscision?

16

If I understand what was in QtM’s link…

…A baby’s foreskin is stretched out and a ring placed over the glans. Then the foreskin is cut just below the edge of the foreskin, right?

What happens to the frenum? Does it come off in the same operation?

Honestly, I have all the basic ingredients but I don’t know what to do with them (not that I’d ever try and circumcise myself)

17

I must say that QtM’s description of the procedure is quite a bit different from the traditional Jewish method (and takes a lot longer, apparently).

Roughly (from my son’s bris, where I didn’t look too closely):

  1. The mohel (the trained ritual circumciser) used a blunt proble to gently separate the foreskin from the glans (Elapsed time: approx. 2 seconds)
  2. The foreskin was pulled forward past the end of the glans and clamped. Think of pulling the neck of a turtleneck sweater up past the top of your head and closing it up with a disk shaped clamp that’s split along a diameter–the two halves close with the neck (foreskin) between them. (Elapsed time: approx 10 seconds)
  3. A razor sharp knife is run along the clamp to shear off the exposed bit of foreskin. (Elapsed time: 2 seconds)
  4. Clamp released, antibiotic ointment applied, baby diapered, given a bit of grape juice soaked gauze to suck on, followed by Mommy’s breast. (Elapsed time: a couple of minutes)

Mazel tov! Everybody eat!

Seriously, the rest of the ceremony (prayers, naming of the child, etc.) took 10 times as long as the actual operation, which is done in under a minute.

-Rick

18

I’m not in the least bit squeamish about such things usually, but I damn near fainted reading QtM’s description.

19

RickG’s description is how I would have do it my… I mean, how I imagined it might happen :o :stuck_out_tongue:

20

Oh sure, like anybody wants a snack now…

:wink: