The key feature of the Plastibell method is the use of the “bell”. This method causes the foreskin foreskin to fall off naturally by blocking blood supply, in a similar fashion to how an umbilical cord falls off. This contrasts with surgical methods where a cut is made to remove the foreskin – this will involve bleeding and require suturing to close the wound. Minimal bleeding and the lack of sutures are some of the key benefits with this device.
The procedure starts by ensuring adequate pain control. Many forms of pain relief exist including local anaesthetic injections, and topical local anaesthetics such as creams and sprays. The ideal regimen for a pain-free circumcision is a topical application plus an injection given by experienced hands. The local anaesthetics obtains a high level of pain control however other forms of sensation are still intact so the procedure may remain uncomfortable for the child. How these sensations are interpreted is variable, and depends on the child’s level of anxiety and calmness. That’s why we use also use multimedia devices to engage the child. encourage parents of slightly older children to be calm and recommend parents read of our advice about psychologically preparing a child for circumcision.
After the anaesthetic, an antiseptic is applied and the area is gently cleaned with swabs. A small incision is made from the tip of the foreskin down towards the middle of the penile shaft to allow for the bell to be inserted:
The bell is placed around the glans (head of the penis):
The foreskin is pulled over the device. A suture (surgical string) is tied tightly around the ring from the outside of the foreskin. This string blocks blood flow to the foreskin. Excess foreskin, that is now without blood supply and therefore at low risk of bleeding, is now surgically removed for a more hygienic healing process.
Depending on the level of pain at this point, a judgement is made as to whether more anaesthetic may be useful. The IMC never charges an extra fee for additional anaesthetic post-operatively as our goal is to provide a pain-free, or as close as is possible to get to a pain-free, circumcision procedure.
During the healing and recovery process, the area might be sore and sensitive so it is important to use the oral analgesic and ointment we give and ensure prompt nappy changes. After-care information to achieve a comfortable and healthy recovery will be provided in printed form on the day of the procedure. As the blood flow is now restricted to the foreskin, it will fall off naturally along with the bell around a week later or a bit longer for older children. By the time the ring falls off, the healing process would be complete. The result will be a neat cut due to the perfectly circular line formed by the string.
