Surgeon 1 used thermocautery in all of the circumcisions he performed, while surgeon 2 used either the surgical circumcision or Alisklamp technique.
However, thermocautery and the clamp can be applied in sterile conditions in a circumcision room.
The thermocautery device also provides coagulation during the circumcision process, because it converts electric energy into heat energy.2,9 Minimal interventions is only needed in dorsal vein or frenular artery bleeding during the circumcision.
In electrocautery circumcisions, the electrical current passes directly through the penile tissue, and if the preputium is cut by electrocautery after being clamped, there can be total phallic loss (grade V injuries) due to direct contact between the cautery and the clamp.10,11 Electrocautery and thermocautery work on different principles.
More edema occurs in the penile skin proximal to the clamp when compared to the surgery and thermocautery techniques.
Surgical periods varying from 3.6 to 11 minutes have been reported in the literature when using the clamp technique.13,14 In the open surgical technique studies, it was reported that the surgical process took longer than 20 minutes.15 In accordance with the literature, in our study, the clamp and thermocautery techniques were found to be superior to the classical surgical technique.
In terms of cost, one Alisklamp for each clamp circumcision, the thermocautery device and one absorbable suture for each thermocautery technique, and one absorbable suture for each open surgery were the considered costs when the common expenses were ignored (personnel, sterility, surgical set, and medical dressing).
These calculations were made using the January 2015 exchange rate of 1 USD=2.40 TL.17 There are not many studies in the literature about the thermocautery technique in circumcisions.
Also thermocautery technique was performed by the first author and the other techniques were performed by the second author.