Bipolar electrosurgery versus thermocautery in circumcision with safe anesthetic techniques

Background
Circumcision is one of the most common surgical procedures. Several techniques and devices have been used for circumcision, of them, bipolar electrosurgery and thermocautery devices are widely used.
Objective
To compare the safety and efficacy of bipolar electrosurgery versus thermocautery in the circumcision of infants under combined general and local anesthesia.
Patients and methods
This was a prospective randomized study comparing two techniques of male circumcision, carried out on 120 infants enrolled for circumcision at Damanhour Teaching Hospital, El-Beheira, Egypt, between September 2022 and January 2023. Infants were randomly allocated into two equal groups assigned to circumcision. All infants were circumcised by bone-cutting forceps, whereas in group A, cutting the foreskin with a scalpel and achievement of hemostasis with bipolar electrosurgery, and in group B, cutting the foreskin and achievement of hemostasis using thermocautery.
Results
There were no statistically significant differences between both groups as regards demographic data, time to emerge from anesthesia, and intraoperative complications. The operative and anesthesia duration were significantly prolonged in group A than in group B. Penile edema, postoperative pain, and analgesic consumption were significantly lower in group A than in group B. Four-week follow-up demonstrated no statistically significant differences between both groups.
Conclusion
Bipolar electrosurgery significantly decreases penile edema, postoperative pain, and analgesic consumption, but with an increase in operative and anesthesia duration. The use of thermocautery is a fast and safe method for circumcision but with significant penile edema, postoperative pain, and analgesic consumption.