Evaluation of Gomco clamp in neonates and early infant male circumcision in a private hospital: a series of 300 cases

Aim
The aim of this study was to evaluate the impact and safety of neonatal circumcision under a uniform hospital policy using a Gomco clamp and its complication and parents' satisfaction.
Patients and methods
A prospective analysis of 300 consecutive cases of neonatal and infant circumcisions performed with a Gomco clamp at Al Omooma Private Hospital, Kuwait, during the period from March 2012 through March 2015, was carried out. Outcome measures for the study were the number and type of complications in terms of procedure, the adequacy of circumcision, and parents' satisfaction with the final appearance.
Results
An overall 10.6% of cases suffered from intraoperative bleeding, most of which were controlled by means of chemical hemostasis or bipolar diathermy, whereas 2.6% of cases needed vicryl plus 5/0 stitches. All of them were older than 2 weeks. Two cases (0.67%) returned on the same day of discharge with surface oozing; both cases were sutured with vicryl plus 5/0 stitches. The overall percentage of postoperative bleeding that needed sutures was 3.3% (10 cases). All cases of significant bleeding requiring stitches were older than 14 days (mean age, 38 days). Four parents (1.3%) came during the follow-up period complaining of inadequate circumcision; only one of them needed a redo after 6 months of follow-up. 0.67% of cases suffered from frenulum ulcer and only 1% of patients.
Conclusion
Circumcision with a Gomco clamp is a safe and effective technique with satisfactory cosmetic results, provided care is taken in exact marking of the site on the foreskin for excision and selecting a correct size of the clamp. Gomco clamp is a bloodless, sutureless, simple, and safe method of circumcision in the neonatal period and in early infancy. The use of the Gomco clamp for circumcision beyond early infancy (3 months of age) has substantial morbidity.