Circumcision in Manitoba with the Pollock Technique
Circumcision in Manitoba with the Pollock TechniqueJack Roberts2017-06-14T18:53:00+00:00
Dr. Jay’s Circumcision Procedure – Step by Step
In the case of a baby or young child circumcision, it is best to have finished feeding your son just before bringing him to see the circumcision doctor, so that he will not be overly hungry while you are waiting in the office. If your baby is hungry when you arrive, you can feed him at any time during your visit.
Please read on to learn about the multiple steps we will take to minimize discomfort during the short circumcision procedure. Our doctor will take good care of your son (or of you in the case of an adult circumcision). Parents will be present the whole time during an infant or boy procedure.
You will be at our Winnipeg circumcision clinic for just over an hour, and we want to make that time as pleasant as possible. The total time is about the same for all age groups, but the actual procedure is a bit longer for boys and adults due to the extra step of skin glue application. In any case the procedure is completed in a few minutes. All the following steps are taken to ensure minimal discomfort.
Tylenol Before You Come to the Winnipeg Clinic
First, give your son Tempra or Tylenol drops (also called acetaminophen) just before you leave home or, if you are traveling a long distance, after you arrive at the clinic. Infant acetaminophen drops usually come in a concentration of 80 mg/1 ml (check the bottle that this is the correct preparation). The proper dose for his weight is shown in the table below.
For older boys and adults take one or two 500 mg Tylenol 30 minutes before the procedure.
0.5 ml – 0.6 ml
0.65 ml – 0.8 ml
0.85 ml – 0.95 ml
1.2 ml – 1.4 ml
1.5 ml – 1.7 ml
If you are uncertain of the proper dose after reviewing this, please give us a call for advice so we can guide you to administer the right amount. Please do not give any other medication besides Tylenol or Tempra (i.e., No Ibuprofen, Advil, Motrin, etc.) because it may increase bleeding time.
In our office, your child will have topical anesthetic applied to his penis. This is an anesthetic cream that numbs the skin. This surface painkiller is the second step we take to minimize discomfort during circumcision. This part of the procedure is much the same for all age groups
Pain Blocking Injection – Local Anesthetic
Next, once the skin is numb, the patient will be given an injection called a dorsal penile ring block into the soft tissue alongside the penis. Our doctor uses a combination block of both short and long acting anesthetic. This provides comfort and coverage for both the procedure and for hours after.
Since the topical anesthetic has already numbed the skin, the injection is hardly felt. After a few minutes minutes, the penis is “frozen”, and the circumcision can be done.
Distraction During the Brief Circumcision Operation
During the injections and the circumcision, babies will receive a sugar pacifier to suck on. During the circumcision soothing music is played, room temperature is increased and your baby son may continue to receive sugar pacifiers to suck on for additional comfort. Studies show that the sweet flavours distract babies and reduce their perception of pain.
For older kids and adults candy may be provided, and the patient will be entertained by their choice of television or movies to help them be at ease during the procedure.
Although the circumcision takes just a few minutes, we request that you be in the clinic for about one hour in total.
During the post circumcision observation period we will also carefully review with you all post procedure care and answer your questions before you take your child home.
Caring Team Always Available
As parents we understand that safety concerns are always number one. For your peace of mind, Doctor Jay will be reachable 24 hours a day.
All clients are given our 24-hour contact information so they can reach the doctor directly should any concerns arise. In the unlikely event of a problem after the circumcision you will have fast answers to your questions or concerns.
The Penis Before & After Circumcision
The three images below show the change in your boy’s penis brought about by circumcision.
1. A profile of the uncircumcised penis with the foreskin covering the glans (head of the penis).
2. The same penis as in Figure 1 but drawn as if the foreskin was transparent. Here you can see the foreskin in relation to the inner side of the foreskin and the glans. Notice the adhesions along the inner side of the glans. These are present at birth in almost all babies and must be released before the actual circumcision.
3. The same penis following the circumcision. Notice that the cut edge of the skin retracts to just behind the back rim of the glans. This is the site of healing.
Our Circumcision Method and Pain Control Approach
The Pollock Technique used by Dr. Jay is based on the Mogen technique. This technique is known for its quickness and safety. In conjunction with this method, our circumcision doctor uses the most complete and extensive pain control methods available. This ensures that your son will feel little or no pain at all. The objective of the Pollock Technique is to minimize stress on the infant and family via maximum pain control and a quick and simple procedure.
Methods used by other Manitoba circumcision doctors
Doctor Jay uses the Pollock Technique for all circumcisions. Other doctors and clinics use other techniques, and here are examples of the more common methods used by physicians at other clinics or circumcision providers in Winnipeg and beyond. We mention just two of the more common alternate methods here and this is not intended to be an exhaustive list of circumcision types.
The Gomco Clamp – Not used at Buenafe Clinic
This is the most common technique used by general practice physicians who are not specialized in circumcision. It requires much longer to perform and involves more tissue handling. The technique involves compression of the foreskin for five minutes prior to incision.
The clamp is left in place long enough to allow clotting to occur, then the foreskin is removed using a scalpel. The clamp’s base and bell are then removed from the penis. The clamp itself must be rigorously sterilized prior to surgical use. Dr. Jay does not use this method.
The Plastibell – Not used at Buenafe Clinic
With this technique, the baby must go home with a small plastic device tied on to his penis that allows the foreskin to desiccate over subsequent days. This is also a lengthier procedure to perform. Our opinion is that there is no need to introduce a surgical device that stays on the baby’s penis for up to a week.
The Plastibell Circumcision Device is a clear plastic ring with a deep groove. The Plastibell is placed onto the head of the penis during a 10-minute surgical procedure, and the device will fall off within a week. Dr. Jay does not use this method.
Dr. Neil Pollock
At Buenafe Clinic, we use the Pollock Technique for circumcision procedures for all ages of babies, boys, and adult men.
Our doctor, Dr. Jay Buenafe, has trained with the renowned Dr. Neil Pollock at his clinics in Vancouver, and has been certified in the use of this superior circumcision surgery technique.
The detail above on this page is somewhat focused on how we apply our method for infant circumcision, so please visit the adult circumcision page or the teen circumcision page if you would like more information on circumcision at an older age.
Extensive pain control methods are employed for all ages; including Tylenol, topical freezing cream, and a long acting local anesthetic. Older boys and adult men also benefit from a virtually painless procedure.
Is Our Doctor’s Circumcision Method Like Plastibell?
The Pollock Technique can be used for babies, boys, and men of all ages, and consists of using a Mogen clamp under long-acting local anesthetic. This method is quite different from the Plastibell procedure in that it is faster and there is no device left attached to the penis after the surgery.
Our circumcision doctor performs Pollock Technique circumcisions for infants, babies, boys, teens, and adult men. The Pollock Technique circumcision operation takes only one minute for newborns – and this is 10 times quicker than most hospital circumcisions. This is different from the Plastibell circumcision procedure where an infant circumcision requires 10 minutes to affix the Plastibell device to the baby’s penis and it remains in place for up to 7 days.
We find the Pollock Technique to be the most safe and gentle circumcision method practiced in Canada today. Only local anesthetic is needed and recovery time is relatively fast. Our method is quicker than other procedures, and has proven safe over the past 25 years and 50,000 procedures. This is one of the reasons why so many Manitoba doctors refer their patients to our Winnipeg circumcision clinic.