Circumcision Procedure using the Tara KLamp Disposable Non-invasive [sic] Circumcision Device

1 The penis is first cleansed with sterilizing fluids. Use surgical marking pen to mark the level on the skin of the prepuce where the circumcision is to be performed. This is the level where the clamp is to be applied. This prevents too much pulling of the prepuce and thus avoids removal of too much tissue.

2 Gently retract the prepuce. Free any adhesions, if they are present. [CIRP note: Lysis of the synechia is definitely invasive and painful in the case of infant circumcision: See 'PlastiBell' method.]

3 As shown, apply Vaseline:-to the inner and outer surfaces of the lower end of the tubular part and to the inner and upper part of the ring.This prevents the tissue from sticking to the device over the next few days.

4 Place the tubular part of the clamp over the glans, so that the glans is covered by the tube.

5 The prepuce is now pulled over the rim of the tube. Adjust the prepuce over the tube so that the level which has been marked earlier is just above the rim of the tube.

6 After adjusting the level of the prepuce, hold the prepuce firmly with the fingers.

7 A grip-like pressure is applied on the two arms. As this pressure is increased, the two arms are brought closer to the locking mechanisms on the tube.

8 Resistance to further movement of the arms is felt when the arms come in contact with the locking mechanisms on the device. Apply further pressure on the arms until two clicks are heard and felt. This means that the arms are already locked and the necessary occlusion has been obtained.

9 With the tissue cutter provided, the prepuce that is distal to the clamping ring is cut away at the angle between the tube and the clamping ring.

10 Although there is no bleeding, the tube is cleaned with a clean gauze and ointment is applied at the cut edge. Apply the ointment a few times daily, during the next few days. The device is allowed to remain on the penis for the next few days. Urine is easily voided through the distal opening.