Gomco Clamp
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Gomco Clamp
Circumcision surgical procedure in males involves either a conventional "cut and stitch" surgical procedure or use of a circumcision instrument or device. In the newborn period (less than 2 months of age), almost all circumcisions are done by generalist physicians using one of three surgical instruments. In the US, the Gomco clamp is the most utilized instrument, followed by the Mogen clamp and the Plastibell. They are also used worldwide. Complications may include bleeding, infection, reduction in sensation of the glans penis, and too little or too much tissue removal. Deaths are rare. After the newborn period, circumcision has a higher risk of complications, especially bleeding and anesthetic complications. In the 21st century, most circumcisions in boys and men are performed using one of three open surgical methods. The forceps-guided method, the dorsal slit method, and the sleeve resection method are well described by the World Health Organization in their Manual for Male ...
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Surgical Procedure
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function, appearance, or to repair unwanted ruptured areas. The act of performing surgery may be called a surgical procedure, operation, or simply "surgery". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The person or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who practices surgery and a surgeon's assistant is a person who practices surgical assistance. A surgical team is made up of the surgeon, the surgeon's assistant, an anaesthetist, a circulating nurse and a surgical technologist. Surgery usually ...
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Glans
The glans (, plural "glandes" ; from the Latin word for "acorn") is a vascular structure located at the tip of the penis in male mammals or a homologous genital structure of the clitoris in female mammals. Structure The exterior structure of the glans consists of mucous membrane, which is usually covered by foreskin or clitoral hood in naturally developed genitalia. This covering, called the prepuce, is normally retractable in adulthood. The glans naturally joins with the frenulum of the penis or clitoris, as well as the inner labia in women, and the foreskin in uncircumcised men. In non-technical or sexual discussions, often the word "clitoris" refers to the external glans alone, excluding the clitoral hood, frenulum, and internal body of the clitoris. Similarly, phrases "tip" or "head" of the penis refers to the glans alone. Sex differences in humans In males, the glans is known as the glans penis, while in females the glans is known as the clitoral glans. In fema ...
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Asepsis
Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is derived from the older antiseptic techniques, a shift initiated by different individuals in the 19th century who introduced practices such as the sterilizing of surgical tools and the wearing of surgical gloves during operations. The goal of asepsis is to eliminate infection, not to achieve sterility. Ideally, a surgical field is sterile, meaning it is free of all biological contaminants (e.g. fungi, bacteria, viruses), not just those that can cause disease, putrefaction, or fermentation. Even in an aseptic state, a condition of sterile inflammation may develop. The term often refers to those practices used to promote or induce asepsis in an operative field of surgery or medicine to prevent infection. History The modern concept of asepsis evol ...
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Plastibell Circumcision Device
Circumcision surgical procedure in males involves either a conventional "cut and stitch" surgical procedure or use of a circumcision instrument or device. In the newborn period (less than 2 months of age), almost all circumcisions are done by generalist physicians using one of three surgical instruments. In the US, the Gomco clamp is the most utilized instrument, followed by the Mogen clamp and the Plastibell. They are also used worldwide. Complications may include bleeding, infection, reduction in sensation of the glans penis, and too little or too much tissue removal. Deaths are rare. After the newborn period, circumcision has a higher risk of complications, especially bleeding and anesthetic complications. In the 21st century, most circumcisions in boys and men are performed using one of three open surgical methods. The forceps-guided method, the dorsal slit method, and the sleeve resection method are well described by the World Health Organization in their Manual for Male ...
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Necrosis
Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. Necrosis is caused by factors external to the cell or tissue, such as infection, or trauma which result in the unregulated digestion of cell components. In contrast, apoptosis is a naturally occurring programmed and targeted cause of cellular death. While apoptosis often provides beneficial effects to the organism, necrosis is almost always detrimental and can be fatal. Cellular death due to necrosis does not follow the apoptotic signal transduction pathway, but rather various receptors are activated and result in the loss of cell membrane integrity and an uncontrolled release of products of cell death into the extracellular space. This initiates in the surrounding tissue an inflammatory response, which attracts leukocytes and nearby phagocytes which eliminate the dead cells by phagocytosis. However, microbial damaging substances released by leukocytes would cre ...
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Ligature (medicine)
In surgery or medical procedure, a ligature consists of a piece of thread (suture) tied around an anatomical structure, usually a blood vessel or another hollow structure (e.g. urethra) to shut it off. History The principle of ligation is attributed to Hippocrates and Galen. In ancient Rome, ligatures were used to treat hemorrhoids. The concept of a ligature was reintroduced some 1,500 years later by Ambroise Paré, and finally it found its modern use in 1870–80, made popular by Jules-Émile Péan. Procedure With a blood vessel the surgeon will clamp the vessel perpendicular to the axis of the artery or vein with a hemostat, then secure it by ligating it; i.e. using a piece of suture around it before dividing the structure and releasing the hemostat. It is different from a tourniquet in that the tourniquet will not be secured by knots and it can therefore be released/tightened at will. Ligature is one of the remedies to treat skin tag, or acrochorda. It is done by tying st ...
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Randomized Controlled Trial
A randomized controlled trial (or randomized control trial; RCT) is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical techniques, medical devices, diagnostic procedures or other medical treatments. Participants who enroll in RCTs differ from one another in known and unknown ways that can influence study outcomes, and yet cannot be directly controlled. By randomly allocating participants among compared treatments, an RCT enables ''statistical control'' over these influences. Provided it is designed well, conducted properly, and enrolls enough participants, an RCT may achieve sufficient control over these confounding factors to deliver a useful comparison of the treatments studied. Definition and examples An RCT in clinical research typically compares a proposed new treatment against an existing standard of care; these are then termed the 'experimental' ...
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Meta-analysis
A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting measurements that are expected to have some degree of error. The aim then is to use approaches from statistics to derive a pooled estimate closest to the unknown common truth based on how this error is perceived. Meta-analytic results are considered the most trustworthy source of evidence by the evidence-based medicine literature.Herrera Ortiz AF., Cadavid Camacho E, Cubillos Rojas J, Cadavid Camacho T, Zoe Guevara S, Tatiana Rincón Cuenca N, Vásquez Perdomo A, Del Castillo Herazo V, & Giraldo Malo R. A Practical Guide to Perform a Systematic Literature Review and Meta-analysis. Principles and Practice of Clinical Research. 2022;7(4):47–57. https://doi.org/10.21801/ppcrj.2021.74.6 Not only can meta-analyses provide an estimate of the u ...
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Hemostat
A hemostat (also called a hemostatic clamp, arterial forceps, or pean after Jules-Émile Péan) is a surgical tool used in many surgical procedures to control bleeding. For this reason, it is common in the initial phases of surgery for the initial incision to be lined with hemostats which close blood vessels awaiting ligation. Hemostats belong to a group of instruments that pivot (similar to scissors, and including needle holders, tissue holders and various clamps) where the structure of the tip determines its function. The hemostat has handles that can be held in place by their locking mechanism. The locking mechanism is typically a series of interlocking teeth, a few on each handle, that allow the user to adjust the clamping force of the pliers. When locked together, the force between the tips is approximately 40 N (9 lbf). History The earliest known drawing of a pivoting surgical instrument dates back to 1500 BC on a tomb at Thebes, Egypt. Later Roman bronze and steel piv ...
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Brit Milah
The ''brit milah'' ( he, בְּרִית מִילָה ''bərīṯ mīlā'', ; Ashkenazi pronunciation: , " covenant of circumcision"; Yiddish pronunciation: ''bris'' ) is the ceremony of circumcision in Judaism. According to the Book of Genesis, God commanded the biblical patriarch Abraham to be circumcised, an act to be followed by his male descendants on the eighth day of life, symbolizing the covenant between God and the Jewish people. Today, it is generally performed by a mohel on the eighth day after the infant's birth and is followed by a celebratory meal known as '' seudat mitzvah''. ''Brit Milah'' is considered among the most important and central commandments in Judaism, and the rite has played a central role in the formation and history of Jewish civilization. The Talmud, when discussing the importance of ''Brit Milah'', compares it to being equal to all other mitzvot (commandments) based on the gematria for ''brit'' of 612. Jews who voluntarily fail to under ...
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American Academy Of Pediatrics
The American Academy of Pediatrics (AAP) is an American professional association of pediatricians, headquartered in Itasca, Illinois. It maintains its Department of Federal Affairs office in Washington, D.C. Background The Academy was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It has 67,000 members in primary care and sub-specialist areas. Qualified pediatricians can become fellows (FAAP). The Academy runs continuing medical education (CME) programs for pediatricians and sub-specialists. The Academy is divided into 14 departments and 26 divisions that assist with carrying out its mission. Publications It has the largest pediatric publishing program in the world, with more than 300 titles for consumers and over 500 titles for physicians and other healthcare professionals. These publications include electronic products, professional references/textbooks, practice management publications, patient education materials, and parenting books. ...
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