Adult Gomco Clamps: Adult Male Circumcision
A Gomco clamp – also called a Yellen clamp – is a special type of surgical tool that is used to perform the Gomco technique for male circumcision. Removing the foreskin with the Gomco clamp and sealing the wound edges with tissue adhesive is the technique employed there.
We stock varying sizes of neo-natal and infant Gomco clamps but would not recommend their use if you have in mind a cosmetic adult circumcision. There are also plasti-bell clamps that fall off after several days.
The issue is the surgeon cannot see precisely what is going on under the clamp, so there is poor control of where the incision line is going to fall and little control as well as whether you will have a high, moderate or low circumcision, and ideal healing of the frenular area if that is resected. The scar tends to be broader and may be deeper, meaning skin will not glide like skin on the rest of your shaft.
While adult Gomco clamps are available but the results are not as precise as with a sleeve resection carefully done to your specifications. In our operating room, the patient has access to a hand held mirror so he can view the operation in progress and comment on the degree of tightness.
I also believe a 2 layered closure with suture provides the best approximation of skin and underlying loose connective tissue.
The Gomco also does not obviate the need for sutures after removal, lest your wound break apart during your first erection. Remember an incision does not have full tensile strength until 7 to 8 weeks after surgery.
Even for infants older than 3 or 4 months a few stitches is a very good idea. By the time they are older than a year, several sutures are needed to ensure continued approximation.
I will not use an Adult Gomco although it is popular in voluntary male circumcision which reduces HIV transmission from female-to-male by 60%. There is a large international effort to offer voluntary circumcision to men living in areas of the world with a high HIV prevalence.
If you are living in an economically challenged country with concern about epidemic spread of HIV, the adult Gomco is a more rapid method, but cosmetically may not be what you envision.
If you do have an Adult Gomco procedure be sure the surgeon sutures your edges together all the way around very carefully as one good erection and you incision line will fall apart.
Our practice and specialization is recognized by the Urology Care Foundation (American Urological Association) http://www.urologyhealth.org/find-a-urologist
For more information, please visit http://adult-male-circumcision.com. We are available for consultation. Our E-mail address: reed@srsMiami.com