Plastibell

Plastibell is a disposable plastic device used for neonatal male circumcision. It consists of a plastic bell or ring and a circumferential ligature that sits at the base of the foreskin. The device is designed to create a controlled circumcision by drawing the foreskin over the bell, tying the ligature tightly, and trimming the excess foreskin.

During the procedure, the foreskin is drawn over the bell and secured with the ligature at the groove of the bell. The remaining foreskin is then removed. The bell stays in place to protect the glans and to allow the tissue to heal around the ligature. Over several days, the foreskin tissue necroses and the device typically detaches along with the healing tissue, usually within about 4 to 8 days.

Postoperative care focuses on keeping the area clean and dry, monitoring for signs of infection or bleeding, and seeking medical advice if there is excessive swelling, fever, or if the device does not detach as expected. Analgesia may be used as advised by a clinician.

Plastibell offers advantages such as avoiding skin sutures and potentially reducing immediate bleeding, and it is commonly performed by trained clinicians in appropriate newborns. However, complications can occur and may include bleeding, infection, swelling, urinary issues, or retained device fragments requiring removal. The choice of circumcision method, including Plastibell, depends on clinical judgment, patient factors, and parental preference, with alternative techniques such as the Gomco or Mogen clamps also in use.