No Needle local Anesthesia and Surgical Techniques

No Needle local Anesthesia

Anesthesia can be accomplished by administering a dorsal penile nerve block, with or without a ring block.

Dr. Shu uses Madjet device to perform the initial no needle anesthesia. A spray applicator (MadaJet®) delivers a stream of anesthetic so fine that it penetrates the skin and diffuses to a depth of about 3/16 of an inch, enough to anesthetize skin and the underneath tissue. Then additional anesthetic is injected with needle through the numbed spots. The introduction of no-scalpel vasectomy has successfully allayed many men’s fears with regard to needle.

Surgical Techniques for Adult Circumcision:

There are two common surgical techniques used for adult circumcision in the US. The dorsal slit technique is recommended when circumcision is indicated for phimosis or paraphimosis. The sleeve resection is the most common circumcision technique used, and it is adaptable for use in both children and adults.

Dorsal Slit Technique

• The extent of the dorsal slit is determined to make sure that the correct amount of prepuce (foreskin) will be removed.
• The slit is made with scissors. The preputial skin should then be excised at its base with scissors.
• Blood vessels are tied off using absorbable stitches or by electrocautery.
• The edges of the foreskin are stitched.
• A sterile dressing of petroleum gauze is applied over the sutures.

Sleeve Technique

• A skin marker is used to delineate the external and internal incisions.
• The external and internal preputial incisions are made.
• The sleeve of skin is excised.
• Blood vessels are tied off using absorbable stitches or by electrocautery.
• The edges of the foreskin are stitched.
• A sterile dressing of petroleum gauze is applied over the sutures.