Minggu, 21 Oktober 2012

HISTORY OF CIRCUMCISION

Male circumcision is a surgical procedure that involves partial or complete removal of the foreskin (prepuce) of the penis. The circumcision on man had started thousand years ago. It was part of the people's culture especially for those who live in the hot climate area such as in Australia, the Pacific islands, and equatorial countries, the Middle East, Africa and the Americas.

Almost all male circumcisions was performed for religious, cultural and medical reasons. Medical indications for circumcision have become more popular since the sharp increase of modern surgery in the 19th century.

Clamp method for male circumcision is actually the oldest method of circumcision practice by mankind. Egyptian mummies and wall carvings record the practice of circumcision with ‘ancient clamp’ over 15,000 years ago. In Malaysia, traditional circumcision among muslim was done by traditional practitioner known as “Tok Mudin’ using simple clamp made up of bamboo, wood or animal horn and the excess skin was cut by sharp bamboo.

In the late 19th and early 20th centuries modern surgery was introduced with availability of local anaesthesia, doctors began performing circumcision surgery with dorsal slit method and now is accepted as a ‘gold standard’ for circumcision. The first generation of modern clamp named ‘GOMCO Clamp’ was introduced in 1934 and then followed by ‘MAYO clamp’ in 1954. These clamp were made up from stainless steel for easy sterilization and they were reusable. This stainless steel circumcision device became obsolete since the prevalence of Hepatisis B/C and HIV hnfection.


 

In 1970 the second generation of circumcision clamp was introduce into the market as a single use, disposable device. It is made up from high quality of plastic material. Plastibell, Taraklamp, Smartklamp ,Sunatron and Ismail Clamp were accepted well into the market with new concept of easy circumcision without any open wound or stitches, less bleeding and no risk of infection.



In 2003 new generation of disposable circumcision clamp device was introduce into the market. It is an overall improvement from the previous second generation circumcision clamp device with new introduction of Aesthetic circumcision concept.


Alisklamp is specially design to fit the natural anatomical shape of glans penis and thus produce perfect aesthetic circumcision. Alisklamp is available for easy and safe circumcision for infants, childrens and adults male. It is a third generation of disposable circumcision clamp device with many advanced improvement and advantages.







 CONVENTIONAL CIRCUMCISION
In the late 19th and early 20th centuries modern surgery was introduced, especially with the newly available of local anaesthesia, doctors began performing circumcision surgery with dorsal slit method. Injection of anaesthetic, dorsal slit done up to back of glans penis follows by circumferential cut up to the frenulum area. All the bleeding point are secured and skin closed with stitches. This dorsal slit technique is now accepted as a ‘gold standard’ for circumcision and practiced by most of the doctors.
Dorsal slit method 



  








Gullotin methode

Artery forcept is use as the ‘clamp device’ and the unwanted skin is excise with scissors and bleeding point are secured and followed by stitches. This technique is faster, less bleeding and usually preferred by the doctor.


LASER CIRCUMCISION
The term "laser" originated as an acronym for Light Amplification by Stimulated Emission of Radiation. A laser is a device that emits light (electromagnetic radiation) through a process of optical amplification based on the stimulated emission of photons. A powerful beam of light that can produce intense heat when focused at close range. Lasers are used in medicine in microsurgery, Aesthetic medicine, cauterization, for diagnostic purposes., etc. For example, lasers are employed in microsurgery to cut tissue and remove tissue.
The used in circumcision is solely for cutting process as in combination of the gullotin technique. Stitches is necessary as conventional method to prevent further bleeding. The main advantages of laser cutting is very precise, sharp and clean cut with minimal bleeding. It only produce a very minimal of burn injury around 0.5 micron.
Most of the laser circumcision offered by ordinary clinic is actually not using laser machine because one laser machine cost more then RM 150,000.00 and it is not cost effective to charge laser circumcision around RM150.00 or less. Usually they used high voltage electrical machine called Electrocautery.

Electrocautery is an apparatus for surgical dissection and hemostasis, using heat generated by a high-voltage, high-frequency alternating current passed through an electrode that consists of a red hot piece of metal, such as a wire, held in a holder. The term electrocautery is used to refer to both the procedure and the instrument used in the procedure. 
Monopolar/unipolar electrocautery is an electrocautery in which current is applied through a handheld active electrode and travels back to the generator through an inactive electrode attached to the patient (the grounding pad), so that the patient is part of the electrical circuit.
Bipolar electrocautery is an electrocautery in which both active and return electrodes are incorporated into a single handheld instrument, so that the current passes between the tips of the two electrodes and affects only a small amount of tissue.
An electrocautery uses a very high frequency, usually upwards of 100 kHz, to ensure that the patient's nerves and muscles are not stimulated. Lower frequencies could cause twitching and cramps, which would be a serious problem. Depending on the voltage used, the electrocautery can have varying effects on the patient's body. 
 
However, there are some cautions hnvolved when using electrocautery. It is important to use the equipment properly and to keep it in good working order to ensure that only the area of interest is coming into contact with heat or electrical current. If electrocautery is not performed with safe equipment, the patient's body could potentially be burned elsewhere.
Electrocautery is not recommended for circumcision used because it can caused many complications likes:

 












  • Cutting using the heat from metal piece can produce deep burn injury and may caused extensive damages to nerve, blood vessels and penile tissues. It is estimated electrocoutry can produce burn injury about 0.5 cm depth and usually produced thick and deep contracted scars tissues.
  • Extensive burn of the penile tissues may caused penile cancer in the future

·     

  •        Electrocautery may burn part of the sensitive nerve and this may leads to chronic short pain due to disturbances in the nerve conductivity
  •         Gangrene of the penile skin or even the tip of the glans penis had been reported due to the heat generated caused acute vasoconstriction and coagulated blood.
  •      Serious permanent injury to the penis may happened and many cases reported involved glandular injury with few cases of penile amputation.
  •        Risk of electrocuted if the equipment is not maintain proper services.

    Circumcision is not for a disease treatment so it is not wise to subject a child for unnecessary serious risk of electrocoutry as mention above, thus many country already ban the used of electrocautery for circumcision, this include Turki.
Flash couter is an improvement of electrocautery which is battery operated and using sharp metal string as an electrode. The main advantages here is low voltage with smaller burn injury and no risk of electrocuted. Circumcision also can be done in no electricity area.

 CLAMP METHOD CIRCUMCISION 
Clamp method for circumcision is the oldest method practice by mankind. Far before the availability of anaesthesia and modern surgery, ancient clamp method was used for quick, easy and less bleeding method for circumcision. Animal horn, wood piece , bamboo or metal piece was used as the ancient clamp in the olders day.




First generation

First generation of modern clamp was invented during the development of modern surgery with introduction of local anaesthesia in 19th centuries. Gomco calmp was produced in 1934 and followed by Mogen clamp in 1954. This two circumcision clamp device were very popular in Europe and US . It was made up from stainless steel for easy sterilization and reusable for unlimited times. Since the spreads of Hepatitis B and HIV infection this device had become obsolete in the market.

Second generation
Second generation of clamp was introduced into the market as disposable product and made up from palastic material. Concept of easy circumcision without any open wound or stitches, less bleeding and no risk of infection. Plastibell and Taraklamp are the pioneer int the disposable circumcision clamp device. Smartklamp, Sunathrone and Ismail clamp are available at later stage for an option of disposable circumcision clamp device.

Plastibell ( "Cincin" )
Taraclamp

Smartklamp
Sunathrone
Third generation
Alisklamp is the latest disposable clamp device design with comprehensive improvement from the second generation bircumcision clamp device. The unique design of slunting tube is patented world wide. Alisklamp is naturally fit with anatomical shape of glans penis and thus able to produce a perfect male circumcision for infant, childrens and adults. It is a third generation of disposable circumcision clamp device with many advanced improvement and advantages.














RUMAH KHITAN SURABAYA-SIDOARJO


“SOLUSI KHITAN SEHAT”

Menyediakan berbagai metode khitan inovasi terbaru

untuk anak-anak, remaja dan dewasa


PUSAT KHITAN

Metode Cincin
Smartklamp (Alisklamp)
Sunat Laser /Flashcutter
Klasik Modif
* BONUS CELANA KHITAN
* KONTROL GRATIS SAMPAI SEMBUH (DIJAMIN)
BISA KE RUMAH
HUBUNGI KAMI :
Klinik sunat Rumah Khitan Surabaya-Sidoarjo
Jl. Kol.Sugiyono No.5, Ngeni, Kepuh Kiriman, Waru, Sidoarjo.
Telp. 031-70719505, 081230193930
Homepage :





2 komentar:

  1. Jual Sewa Perumahan Rumah Tanah kavling Gudang Ruko Sidoarjo

    BalasHapus
  2. MANAZELA RESIDENCE Lokasi Strategis:
    1. nol jalan raya
    2. 15 mnt dr exit tol kota sidoarjo
    3. Harga Masih Promo
    4. UM Minim Cuma 10jt, buruan sebelum Promo Habis
    5. Cicilan 2,4 jutaan
    6. Bonus TV LED 32 Inc Selama Masih Promo

    Hub.lyas
    031.8324.8642
    081.331.408.879
    0857.3155,2682
    Pin BBM : 2800B9FF

    BalasHapus