Comparison of newborn circumcision: Mogen vs. Gomco vs. Plastibell
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Citation
Abstract
Circumcision of infant males has been a medical procedure that has been performed for thousands of years. Over the centuries, there have been multiple techniques that have made the procedure more efficient, safer, less painful, and easier to perform. The three techniques that were the most common and preferred were the Mogen, Gomco, and Plastibell techniques [Bailey, 2017]. This literary thesis is a retrospective study that looks to previously published papers to determine the preferred circumcision method. This analysis is not in support or in opposition to the topic of circumcision, but rather to promote a uniform understanding of the various techniques. The benefit of such standardization will provide uniform training for providers, better care for patients, and minimized risk of complications.
In this analysis, the Gomco, Mogen, and Plastibell methods are compared in terms of safety, pain, and provider preference. A randomized control trial determined that the Mogen clamp is associated with less pain and discomfort, and is safer, faster, and preferred by surgeons [Sinkey 2015]. Surveys from various providers show that Mogen clamp was the preferred method for circumcision, stating that it has many benefits: the instrument has only one piece, one size can be used for all patients, and it can be reused [Abdulwahab 2013]. Additionally, the Mogen clamp took the least amount of time to complete and required the fewest number of procedures for the providers to develop competency [Abdulwahab 2013, Bailey 2019]
The Mogen clamp was associated with the least amount of pain in a study analyzing the physiological response of a newborn. The study showed that the Mogen clamp had the lowest absolute and percentage change of cortisol levels [Sinkey 2015]. Kurtis et al reported that neonates in the Mogen group, regardless of anesthesia type, had less physiological changes such as heart rate and respiratory rate. However, despite Mogen having a faster procedure time and a lower change in cortisol levels between pre and postoperative groups, there was no difference in CRIES scores between circumcision groups [Sinkey 2015].
Of the three devices Mogen appears to be the best choice for circumcisions. However, additional research is needed to find or devise a new device to address shortcomings of current methods.