Introduction

1. No. 140 Bipolar diathermy circumcision and related procedures – A safe and efficient technique) Matthew Winter, Rachel Kour, Nam-Wee Kour, Paul Ruljancich Eastern Health Urology, Victoria Posters Proudly Supported by: • Introduction • Circumcision is one of the most commonly performed and ancient surgical procedures (1,2). Despite the longevity of circumcision the current surgical approach and instrumentation is extremely varied. a b c Figure 2. (a) ventral slit (b) during circumferential excision with left side completed (c) fully completed circumcision prior to closure (note lack of bleeding and neatness of would) • Aim • To present the novel technique of ‘bipolar diathermy circumcision and related procedures’ in adult males. • Results • Table 1. Bipolar procedures performed • Mean age 34yrs, minimal to no intra-operative bleeding all cases. • All patients were requested to attend outpatient reviews, 5 patients failed to return with mean follow-up of 49 days. • All 49 patients had well healed wounds with excellent cosmesis. • Table 2. Complications over 54 bipolar cases (No patient required hospital attendance) • Methods • We reviewed our technique of bipolar circumcision and related procedures over a 22-month period at our day procedure centre. • All procedures were carried out by a resident assisted by the fellow and performed under general anaesthesia. • Bipolar diathermy cutting and haemostasis was performed using bipolar forceps with a 'Valleylab' machine set at 15. • “Sleeve” circumcision involved the following steps: • Dorsal slit • Frenularrelease • Ventral slit • Circumferential excision (Figure 1 and 2) • Closure with interrupted 4/0 ‘VicrylRapide’ Conclusions The bipolar diathermy technique is a simple procedure, easily taught and reproducible. It is associated with minimal bleeding; is safe and efficient and uses routine operating theatre equipment. It is associated with minimal post-operative complications and is associated with excellent cosmesis. a b Figure 1. (a) dorsal slit (b) frenular release Acknowledgements Special thanks to Dr Nam-Wee Kour for surgical technique and photographs. References Fraser ID, Tjoe J. Circumcision using bipolar diathermy scissors: a simple, safe and acceptable new technique. Ann R Coll Surg Engl. 2000 May: 82:190-1 Peters RT, Fisher R. Paediatric circumcision using bipolar diathermy. Ann R Coll Surg Engl. 2009 Jul: 91:436