Adult male circumcision with a circular stapler: Is this the new standard?

Abstract

Introduction: Circumcision is a simple procedure, but it is not free from complications. New methods have recently been developed, including the circular stapler CircumCYS^®.

Material and methods: This a retrospective analysis of our institutional series of 80 consecutive procedures. The stapler consists of a inner bell (in six different sizes), that it is designed to protect the gland, a pistol with a trigger, a circular scalpel and a stapler for the suture. The circumference of the penile shaft is measured at the level of the balano-preputial fold with the provided device. No antibiotic prophylaxis was necessary. A Dorsal Penile Nerve Block (DPNB) were performed by the urologist. Data were collected from medical records 14 days and 1 month after the surgery. Complication rate and Visual Analog Scale were investigated.

Results: Eighty patients were treated between August 2023 and January 2024. The average operating time was 10 min (ds 6). Postoperatively we observed three scar edemas and two minor bleedings. The most common complication was the incarceration of the metal stitches within the scar (five cases). The average time for the stitches to fall out was 24.9 days (ds 3.9). Pain was consistently well-controlled (Visual Analog Scale 2/10 one hour post-surgery - ds 0.8).

Conclusion: CircumCYS^® is a reliable, safe and easy-to-use tool. The technique is very fast and this allows the execution of many circumcisions in a single session. The learning curve appears minimal.