Clamping & Occluding

  • Allis Forceps

    Allis Forceps

  • Kelly Forceps

    Kelly Forceps

  • Mosquito Clamp – Straight

    Mosquito Clamp – Straight

Cutting & Dissecting

  • Metzenbaum Scissor

    Metzenbaum Scissor

  • Straight Mayo Scissor

    Straight Mayo Scissor

Grasping & Holding

  • Adson Forceps

    Adson Forceps

Retracting & Exposing

  • Freer Skin Hook

    Freer Skin Hook

Procedure supplies:
Minor Instrument Set (small emergency), Hand tray, Needle Tip for electrocautery pencil, #15 blades, 1″ vaseline gauze, 2″ conform, & 1″ Coban, Webster needle holder, Adson’s without teeth, Straight Kelly’s/Small Mosquitos, Raytecs, General pack, Laparotomy drape, Med cups, Betadine, .25% Marcine 1:1 with 1% Lidocaine, bacitracin ointment to coat Chromic Gut suture, 10ML syringe & 25-g 1 & 1/2″ needle.

Patient Position: prone.
Skin Prep: External genitalia; retract foreskin if patient’s condition allows.
Draping: Towel over scrotum & additional towels to square off; adult or pediatric laparotomy drape.

Procedure:
1- Straight hemostat is applied to the posterior midline of the foreskin to provide hemostasis as well as mark the incision.
2- The clamp is removed & a dorsal slit is created. 2 hemostats will be placed on the skin edges of the tip of the dorsal slit & traction applied to straighten out the skin folds to facilitate the surgeon performing the next step. #15 blade is used to make incision.
3- A circumferential freehand cut around the shaft is carried out as far back as the surgeon determines appropriate. If 2 incisions were made, the surgeon will cut around the shaft to remove one piece of tissue & perform the second cut to remove the other piece of tissue.
4- If frenulectomy is to be performed, it may be accomplished at this time. Scissors or cautery may be necessary.
5- Raw edges of the small remainder of the foreskin are pulled together and sutured, leaving the glans and frenulum exposed. Provide Chromic Gut suture on short needle holder & Adson tissue forceps with or without teeth. Suture will be run through bacitracin ointment.
6- Nonadherent dressing is loosely applied to the distal penis.

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