Bipolar scissors circumcision is a safe, fast, and bloodless procedure in children

• Published in: Journal of pediatric surgery 2009-10, Vol.44 (10), p.2048-2053
• Main Authors: Méndez-Gallart, Roberto, Estévez, Elina, Bautista, Adolfo, Rodríguez, Pablo, Taboada, Pedro, Armas, Azucena L, Pradillos, Jose M, Varela, Ramiro
• Format: Article
• Language: English
• Subjects: Adolescent; Bipolar scissors; Blood Loss, Surgical - statistics & numerical data; Circumcision; Circumcision, Male - instrumentation; Circumcision, Male - methods; Edema - epidemiology; Edema - etiology; Electrocoagulation - methods; Electrocoagulation - utilization; Humans; Male; Outcome Assessment (Health Care); Pediatric; Pediatrics; Penis; Phimosis; Phimosis - surgery; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prospective Studies; Safety; Surgery; Surgical Instruments - utilization; Time Factors; Urologic Surgical Procedures, Male - methods; Urologic Surgical Procedures, Male - utilization
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2009.06.008

Abstract Purpose The aim of this study is to evaluate bipolar scissors circumcision by comparing it with standard freehand scalpel procedure. Patients and Methods Data were analyzed from a prospective, randomized study, comparing 2 different surgical techniques for pediatric circumcision: the bipolar diathermy scissors circumcision technique with those of a conventional scalpel technique. A total of 230 pediatric patients younger than 16 years (115 in each arm of the trial) who were undergoing circumcision were reviewed prospectively. Operative time, surgical bleeding, complications, and postoperative morbidity were analyzed. Differences between bipolar scissors circumcision and conventional surgery were compared. Results Median blood loss for bipolar circumcision was 0.2 mL (range, 0-0.8 mL) compared with 2.1 mL in the standard group (range, 0.9-4.2 mL) ( P < .001). Operative time in the bipolar diathermy treated group was significantly decreased compared with conventionally treated patients (10.8 ± 1.2 vs 19.1 ± 2.6 minutes; P < .01). Early and late postoperative morbidity were significantly decreased in circumcised patients who underwent the bipolar circumcision technique as compared with those who underwent the conventional approach regardless of the postoperative edema (22 vs 10; P = .02). Conclusions Bipolar scissors circumcision approach is an effective and safe procedure alternative to the standard scalpel technique in pediatric circumcision with no significant morbidity.