TEKNO KLEM: NOVEL DISPOSABLE DEVICE FOR PEDIATRIC CIRCUMCISION–A CASE REPORT

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Published 2026-01-09
Prahara Yuri Darsono Anwar Indrasyafrudin

Abstract

Objective: This case report aimed to present the use of Tekno Klem, a novel disposable circumcision device. Unlike existing devices, Tekno Klem allows immediate clamp removal, potentially reducing the risk of postoperative complications. Case(s) Presentation: A 6-year-old boy presented to the Urology Outpatient Clinic with difficulty in retracting the foreskin of the penis. Physical examination revealed a non-retractable foreskin with a constrictive ring, classified as grade 3 phimosis. Elective dorsal slit surgery using Tekno Klem device was scheduled. The circumcision procedure using the Tekno Klem device began with measuring the glans size to ensure appropriate device selection. The appropriate Tekno Klem clamp size was selected from the available options: 12 mm, 14 mm, 16 mm, 18 mm, 22 mm, and 27 mm. The preputial skin was marked to define the excision area. The safety tube was then carefully positioned around the glans. Subsequently, the clamp frame was inserted. Once the desired positioning was confirmed, the screw cap was applied, locking the clamp securely in place through its serrated and threaded mechanism. The preputial skin was excised using thermal cautery. After clamp removal, N-butyl cyanoacrylate ointment was applied to protect the wound. The procedure lasted 15 minutes. Discussion: Postoperative pediatric penile perception scored 10, indicating improved penile appearance, while voiding satisfaction scored 5, reflecting favorable functional outcomes. No complications, including bleeding, hematoma, infection, glans injury, meatal stenosis, or delayed healing, were observed. The circumcision site healed properly with satisfactory cosmetic and functional results. Conclusion: Tekno Klem offers enhanced precision, safety, and ease of use over conventional devices, with the potential to reduce complications and optimize outcomes, particularly in settings prioritizing surgical accuracy and patient safety. Keywords: Tekno Klem, circumcision, disposable, pediatric, clamp.


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Keywords

Tekno Klem, Circumcision, Disposable, Pediatric, Clamp

References

Morris BJ, Wamai RG, Henebeng EB, et al. Estimation of country-specific and global prevalence of male circumcision. Popul Health Metr 2016;14(1):4.

Bañuelos Marco B, García Heil JL. Circumcision in childhood and male sexual function: a blessing or a curse? Int J Impot Res 2021;33(2):139–148.

Shabanzadeh DM, Clausen S, Maigaard K, et al. Male circumcision complications – A Systematic review, meta-analysis and meta-regression. Urology 2021;152:25–34.

Ahmed F, Al-wageeh S, Ghabisha S, et al. Catastrophic complications of circumcision by traditional circumcisers. Open Access Emerg Med 2021;13:425–429.

Yuri P, Wiratma MKY. Penile and scrotal skin flap combination for circumcised concealed penis: A novel surgical technique. Int J Surg Case Rep 2024;114:109214.

Zamora Vidal B, Gómez Cervantes M, Ávila Ramírez L, et al. Comparative study of mechanical vs. manual circumcision in the pediatric population: An alternative to the conventional technique? Cirugía Pediátrica 2023;36(4):165–170.

Prabhakaran S, Ljuhar D, Coleman R, et al. Circumcision in the paediatric patient: A review of indications, technique and complications. J Paediatr Child Health 2018;54(12):1299–1307.

Scarcella S, Law YXT, Bravi CA, et al. Does using a laser improve outcomes of conventional circumcision in adult and children populations? Results from a systematic review and meta‐analysis. Andrology 2023;11(1):54–64.

Monroe KK, Razoky P, Murphy S, et al. The length of Gomco Clamp timing and its effect on bleeding. Hosp Pediatr 2021;11(9):1003–1010.

Sinkey RG, Eschenbacher MA, Walsh PM, et al. The GoMo study: A randomized clinical trial assessing neonatal pain with Gomco vs Mogen clamp circumcision. Am J Obstet Gynecol 2015;212(5):664.e1-664.e8.

Chan PS, Penna FJ, Holmes AV. Gomco versus Mogen? No effect on circumcision revision rates. Hosp Pediatr 2018;8(10):611–614.

Altokhais T, Elsarrag A, Khan S, et al. Neonatal plastibell circumcision: does the thread type matter? a prospective randomized study. J Pediatr Urol 2019;15(5):562.e1-562.e5.

Güler Y. Comparison of a modified Mogen clamp and classic dorsal slit circumcision under local anesthesia: A clinical study. Curr Urol 2022;16(3):175–179.

Plank RM, Ndubuka NO, Wirth KE, et al. A Randomized trial of Mogen Clamp versus Plastibell for neonatal male circumcision in Botswana. J Acquir Immune Defic Syndr 2013;62(5):e131–e137.

Kalyanaraman M, McQueen D, Sykes J, et al. Urosepsis and postrenal acute renal failure in a neonate following circumcision with Plastibell device. Korean J Pediatr 2015;58(4):154.

Hamza BK, Ahmed M, Bello A, et al. Comparison of the efficacy and safety of circumcision by freehand technique and Plastibell device in children. Afr J Urol 2020;26(1):66.

Talabi AO, Udie GU, Sowande OA, et al. Bone cutter versus plastibell device in neonatal circumcision: A randomized trial. J Neonatal Surg 2020;9:24.

Huo ZC, Liu G, Li XY, et al. Use of a disposable circumcision suture device versus conventional circumcision: a systematic review and meta-analysis. Asian J Androl 2017;19(3):362.

Fan Y, Cao D, Wei Q, et al. The characteristics of circular disposable devices and in situ devices for optimizing male circumcision: a network meta-analysis. Sci Rep 2016;6(1):25514.

Yuan Y, Zhang Z, Cui W, et al. Clinical investigation of a novel surgical device for circumcision. J Urol 2014;191(5):1411– 1415.

Lv BD, Zhang SG, Zhu XW, et al. Disposable circumcision suture device: clinical effect and patient satisfaction. Asian J Androl 2014;16(3):453.

Zhang Z, Yang B, Yu W, et al. Application of a novel disposable suture device in circumcision: A prospective non- randomized controlled study. Int Urol Nephrol 2016;48(4):465–473.

Han H, Xie D wei, Zhou X guang, et al. Novel penile circumcision suturing devices versus the shang ring for adult male circumcision: a prospective study. International Braz j Urol 2017;43(4):736–745.

Gagnier JJ, Kienle G, Altman DG, et al. The CARE guidelines: consensus-based clinical case reporting guideline development. Case Reports 2013;2013:bcr2013201554–bcr2013201554.

Sohrabi C, Mathew G, Maria N, et al. The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines. Int J Surg 2023;109(5):1136–1140.

Karadag MA, Cecen K, Demir A, et al. SmartClamp circumcision versus conventional dissection technique in terms of parental anxiety: A prospective clinical study. Can Urol Assoc J 2015;9(1–2):10.

Azizoglu M, Risteski T, Klyuev S. Alisklamp versus conventional dorsal slit circumcision: A multicentric randomized controlled trial. J Clin Med 2024;13(15):4568.

Süzen A, Karakuş SC, Ertürk N. Circumcision with plastic Alisclamp technique in 4733 boys: Our experiences to reduce complications. Turk J Med Sci 2021;51(3):1324–1330.

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Department of Urology, Faculty of Medicine/Airlangga University