Name of the Procedure:

Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less)

Summary

Circumcision is a surgical procedure performed on male neonates to remove the foreskin covering the head of the penis. This specific method involves surgical excision rather than using clamping devices or performing a dorsal slit.

Purpose

Circumcision aims to address medical, cultural, or personal reasons, including preventing infections, certain medical conditions, or adhering to cultural or religious practices. Expected outcomes include easier genital hygiene and a reduced risk of certain infections and diseases.

Indications

• Phimosis (tight foreskin that cannot be retracted)
• Paraphimosis (foreskin that cannot be returned to its normal position)
• Recurrent urinary tract infections
• Cultural, religious, or parental preferences

Preparation

• Ensure the baby is fasting (if advised by the physician)
• Discuss any current medications or health conditions with the doctor
• Perform necessary diagnostic tests or health assessments as recommended

Procedure Description

1. The neonate is positioned comfortably, usually restrained to minimize movement.
2. Local anesthesia is administered to numb the area.
3. The surgeon makes precise incisions to remove the foreskin.
4. The edges of the incision are sutured or left to heal naturally, depending on the technique.
5. Antibiotic ointment is applied, and the area is bandaged.

Duration

The procedure typically takes about 20 to 30 minutes.

Setting

Usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Pediatric Surgeon or Urologist
• Nurse
• Anesthesiologist (if needed for administering local anesthesia)

Risks and Complications

• Bleeding
• Infection
• Pain
• Scarring
• In rare cases, penile injury or complications from anesthesia

Benefits

• Reduced risk of urinary tract infections
• Lowered risk of penile cancer
• Prevention of foreskin-related issues
• Easier genital hygiene

Recovery

• Follow doctor's post-procedure care instructions (e.g., applying antibiotic ointment, keeping the area clean)
• Expect minor swelling and discomfort, manageable with prescribed pain relief
• Full recovery typically within 7 to 10 days
• Follow-up appointments as advised by the healthcare provider

Alternatives

• Non-surgical management of foreskin-related conditions
• Delaying or forgoing circumcision
• Pros and cons: Non-surgical methods may avoid immediate surgical risks but might not address all medical or cultural concerns.

Patient Experience

During the procedure, the neonate will feel minimal to no pain due to local anesthesia. Post-procedure, there might be mild discomfort and swelling, manageable with prescribed medication and care.