There are many different methods to consider when performing a circumcision. Each method has distinct advantages and disadvantages which should be considered before proceeding.
The Ring method (the main method I typically use) of circumcision is described in the video below and relies on applying pressure to the foreskin by using a rope. The primary disadvantage is that there is a small ring that goes home with the child and falls off after 7 days. This ring is quite similar in the way it works to the umbilical clamp that your son would have had at birth but it can be frustrating for some parents to care for the ring.
The primary advantage of the ring is that in skilled hands it has the lowest rate of bleeding amongst the four most common methods and given the vast majority of Australian circumcisions are done "in rooms" (which means in a doctor's office rather than an operating theatre) it is worth considering the level of preparation that the facility you are choosing has to manage bleeding should it occur.
The Gomco clamp also relies on pressure but rather than a ring it simply crushes the skin using a metal ring on both the inner aspect and the outer aspect of the foreskin. It is a very effective method of circumcision but in older children beyond 6 weeks of age can have a slightly higher rate of bleeding when compared to the ring.
The Mogen clamp also uses pressure but unlike the ring or Gomco clamp relies on the Doctor to ensure that the ONLY things being crushed are the foreskin being removed and unfortunately there have been cases around the world where there has been significant injyry to the head of the penis and in one case in our hometown of Melbourne where the penis was considered to be partially amputated. I do NOT use this method on any child ever.
Finally a surgical circumcision uses a scalpel to remove the excess skin and then uses stitches to ensure there is no ongoing bleeding and in skilled hands such as a Surgeon's is an excellent and reliable method of performing the procedure. It does have a risk of bleeding however and for this reason I choose the ring to minimise any chances that we will experience any bleeding. I will sometimes need to convert to a surgical circumcision if I am concerned that there is any likelyhood of the ring method failing or if there are any complications with the Ring method. It is also worth noting that many of my surgical colleagues whom I respect greatly and have sent more complex medical cases to all primarily use a surgical circumcision but I believe the circumstances need to be considered given they also typically perform the procedure in an operating theatre and therefore are quickly able to manage bleeding in the best environment possible. This is not always the case when the procedure is done "in rooms".
I hope this information is helpful. I am always happy to answer questions around the different methods and above all else my primary concern is excellent medical outcomes so of course am happy to recommend colleagues who can assist you in achieving your desired outcomes.
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