Novel Circumplast Device for Enhanced Safety in Paediatric Male Circumcision in Pakistan at the 31st Annual Conference of the Association of Paediatric Surgeons of Pakistan

Dr A R Khan Introduced a novel Circumplast Device for Enhanced Safety in Paediatric Male Circumcision in Pakistan at the 31st Annual Conference of the Association of Paediatric Surgeons of Pakistan.

Introduction:

In the dynamic landscape of paediatric surgery, advancements prioritising safety and efficacy are pivotal. The 31st Annual Conference of the Association of Paediatric Surgeons of Pakistan (APSP) witnessed a groundbreaking development as Dr A R Khan unveiled the Circumplast device, which is designed to augment the safety and precision of male infant circumcisions. Attended by 280 Paediatric surgeons, the event marked a substantial progression in Paediatric surgical techniques.

Dr. A R Khan's Pioneering Contribution:

With a three-decade tenure in Paediatric surgery, Dr A R Khan has consistently contributed to refining surgical methodologies, emphasising the safety and well-being of young patients. His extensive experience and commitment to progressive approaches have earned him respect in Pakistani Paediatric surgery.

The Circumplast Device for Paediatric Male Circumcision:

The focal point of the conference was the introduction of Dr. Khan's innovative Circumplast device. This sophisticated apparatus is engineered to elevate the safety and precision standards in Paediatric male circumcisions, a routine procedure performed for cultural, religious, or medical reasons. Dr. Khan's device seeks to streamline the process while mitigating potential risks and complications associated with Paediatric circumcision.

Key Features of Circumplast:

1.     Safety Emphasis: The Circumplast device prioritizes safety by minimising the risk of complications, particularly migration to the penile shaft, a concern observed with alternative devices such as Plastibell.

2.     Precision and Consistency: Ensuring meticulous removal of the foreskin, the Circumplast device guarantees precision and consistency—a critical aspect in circumventing potential complications like preputial adhesions.

3.     Procedure Time Optimization: Dr. Khan's device optimises the circumcision process, reducing procedural durations. This benefits the Paediatric patient and enhances operational efficiency in healthcare settings.

4.     Discomfort Mitigation: Acknowledging the inherent anxiety and discomfort experienced by Paediatric patients, the Circumplast device is meticulously designed to minimize such sensations, fostering a more tolerable experience for young recipients.

31st APSP International Conference:

The conference was an ideal platform for Dr  A R Khan to disseminate information regarding his groundbreaking invention among the Paediatric surgery community. Attended by 280 Paediatric surgeons from Pakistan and abroad, the event facilitated the exchange of knowledge, ideas, and advancements in the field.

Dr Khan's presentation captivated the audience, featuring a live demonstration of the Circumplast device and an in-depth discussion of its potential impact on the future landscape of Paediatric surgery. The ensuing interactive session allowed surgeons to pose questions, share insights, and engage in meaningful discourse about this innovative device.

Conclusion:

Dr. A R Khan's presentation at the 31st APSP International Conference signifies a noteworthy advancement in Paediatric surgery. The introduction of the Circumplast device not only underscores Dr Khan's dedication to innovation but also highlights the collaborative efforts crucial for advancing healthcare practices. As the medical community embraces this pioneering technology, the future of Paediatric surgery appears promising, with an enhanced focus on safety and patient-centric approaches through the utilization of Circumplast devices for secure Paediatric male circumcisions.

Contact the Executive Manager for further information and Circumplast order in Pakistan +92 308 5492563

Become a distributor in the USA and internationally

Circumplast device (FDA approved and UKCA certified) is clinically proven to be the innovative safest disposable male circumcision device. The device has been carefully designed for male newborns and infants. Embossed Medical UK manufactures and distributes the Circumplast all over Australia. USA, Middle East and the UK. 

Our marketing research team has provided us with a sale of the number of Plastibell in the US and south of the USA.  In 2020,  sales of Plastibell devices were 111.4 millions in the US and Southern region, 25%, which is about 28 millions.  Our sales team to market this product assured us they will get a 5% share of the market first year. This shares could increase gradually by 7-10% within 5 years. 

The retail price of Plastibell in 25 units boxes is $7.16 and in 125 units boxes is $5.10 per unit in retail price.   Circumplast device is better than Plastibell and potential replacement for Plastibell in the USA. 

The highest circumcision rate in the USA is in the Midwest with Kentucky, Indiana, Iowa, Ohio, and Michigan all reporting above 80%. The lowest circumcision rate in the Southwest with Nevada, Arizona and California all reporting rates of less than 25%. Even if we capture a 2%  potential market, it will reach 500,000 units sold within 1-2 years. 

Circumplast Circumcision Device has eliminated well-known risks associated with the use of bell-shaped Plastibell devices such as complications arising from the migration of Plastibell, which has been eliminated by the Circumplast design. Circumplast also does close cut the mucosa near the penile glans and protects the head of the penis while healing with options of application of ligature at different five locations to cut the acceptable foreskin. 

Join the Emboss Medical UK team and become a part of our innovative Circumplast producing and distributing the industry’s best circumcision device for the professionals across the world.

RE-AUDIT OF EARLY COMPLICATION ESPECIALLY IMPACTION OF DISPOSABLE DEVICE: IMPROVING OUTCOMES OF CIRCUMCISIONS WITH PLASTIBELL AND CIRCUMPLAST RINGS IN CHILDREN IN A COMMUNITY CLINIC

AIM: To evaluate the early postoperative complications particularly impaction of disposable devices ( Plastibell and Circumplast ) in children’s circumcision procedures under local anaesthesia between different age groups, size and types of rings, and different doctors in a community clinic.
MATERIAL AND METHODS
In our re-audit, the outcome of circumcisions (n=1449) was studied over a 1 year period (May 2016 to April 2017) performed under local anaesthesia, by trained doctors in a community clinic doing Circumplast Circumcisions (CC) (n=470) and Plastibell circumcisions (PC) (n=979). Data was collected prospectively and early postoperative complications especially ring impaction were compared between age of the child, size and types of device, and doctors who have performed the circumcision. Follow-up was arranged if required.
RESULTS
The mean age was 6.5±0.4 months (median 1.6). Overall complication rate was 6.7% (97/1449). There is no significant difference in overall complications rate in CC (7% n=33/470) versus PC (6.5% n=64/979) (p>0.5). Although ring impaction is significantly lower in Circumplast circumcision  (0.4% n=2/470) versus Plastibell circumcision (3.4% n=33/979) (p<0.05) but it has significantly improved from the previous audit (CC 3.2% n=7/208 versus PC 8.7% n=102/1179 – ESPU 2016). There is significantly lower incidence in ring impaction with Plastibell size 1.4 as compared to 1.3, 1.5 and 1.7. There is no impaction in 1.1 and 1.2 sizes. Ring impaction was significantly lower in infants versus over 1 year child (1.5% vs 10% n= 19/1280 vs 17/169, p<0.5) respectively. There is no significant difference in complications (8.5%, 7.1%, 6.5%, 5.8% and 5%) among the five doctors’ cases (p>0.5). Mean follow-up for 354 (24%) children were 14 days (median 6).
CONCLUSIONS
This concludes that no significant difference noted in overall early complications of circumcisions between age of the child, size and types of device used, and among different doctors. However, ring impaction was significantly lower in infants, Plastibell size 1.4 and Circumplast.

Accepted as a poster and presentation in ESPU 2018. This abstract is published at https://congress2018.espu.org/

All children operated at Thornhill clinic, Luton, Leyton Clinic, London and Croydon Clinic, London

ADEQUATE PERI-OPERATIVE MANAGEMENT DECREASES COSMETIC COMPLICATIONS AFTER CIRCUMCISION WITH DISPOSABLE RINGS (CIRCUMPLAST AND PLASTIBELL) IN CHILDREN

Source: ESPU 2017, Thornhill and London Circumcision Clinic, England UK

"We reviewed our experience in treating children with cosmetic complications following non-therapeutic male circumcision (NMC) with Plastibell and Circumplast devices at a community clinic. This study highlights the factors leading to these complications and clinical management to improve the cosmetic appearance.

A retrospective review of 3360 children who underwent Circumplast (CC) and Plastibell circumcision (PC) under local anaesthesia at a community clinic from May 2014 to October 2016. Parents were given detailed information and consented preoperatively to children with potential risks. This was provided verbally and in written format.

All complications were reviewed by a paediatric surgeon. All preputial adhesions were separated under anaesthetic cream. The buried penis was treated conservatively. Incomplete circumcisions were corrected by excision of excess skin.  Acquired phimosis was treated by steroid, simple double incision of the scar and surgical reconstruction. Complications were further looked for CC and PC. Follow-up visits were arranged in all cases.

There is no significant difference in the complications between Circumplast Circumcision  (2.2 % n=22/1002) and Plastibell circumcision  (2.3% n= 55/2357). Preputial adhesions were higher in Plastibell Circumcision  (1.5%) than Circumplast Circumcision  (0.8%) but not statistically significant. 

Children with cosmetic complications following NMC by disposable rings (Circumplast and Plastibell) can be prevented by meticulous perioperative management. Parental education and surgical expertise is required to minimise these complications"

ESPU 2017

Circumcisions with Circumplast has reached to 1000 in number at Thornhill and London (Leyton and Croydon) clinic in October 2016

Circumcisions with Circumplast has reached to 1000 in number at Thornhill and London (Leyton, Oliver Road, and Croydon) clinic in October 2016.

Non-therapeutic male circumcision by the Circumplast device can be safely performed in a community clinic. This novel device decreases the risks of complication especially in children under 3 months of age.

Doctor is using the Circumplast device for children circumcision at Uddevalla, Sweden

Doctor from Sweden was trained at London for the Circumplast circumcision and has started to use Circumplast circumcision device for the  children at his centre. 

He was very impressed with the results of the Circumplast circumcision and design of Circumplast device. 

Outcome of Circumplast and Plastibell at Thornhill Circumcision Centre

This cohort study will evaluate the early postoperative complications in Circumplast and Plastibell techniques, in a community clinic- Thornhill Circumcision Centre, for non-therapeutic male circumcision.

We reviewed the outcome of non-therapeutic male circumcision in children (n=1387) over a 1 year period (May 2014 to April 2015) in a community clinic - Thornhill clinic , performed under local anaesthesia, by trained doctors with the backup of a trained paediatric surgeon (figure 1-4). The technique was selected by doctors’ preference. Data was collected prospectively and early postoperative complications were compared between Circumplast and Plastibell circumcisions. Follow-up consultations were arranged if required.

The mean age was 18 ± 1.9 months (median 5.1) in Circumplast circumcision (CC) and 9.4 ± 0.6 months (median 1.5) in Plastibell circumcision (PC). Incidence of complications is significantly lower in CC (6.3% n=13/208) versus PC (13% n=154/1179) (p<0.05) (complications graph). Postoperative use of antibiotics was higher in CC versus PC (6.7% vs 3.8% n=14 vs 45) but not statistically significant (P>0.05). Mean follow-up consultations were 19 days (range 1 to 373) in CC and 20 days (range 1 to 305) in PC.

Outcome

Non-therapeutic male circumcision by the Circumplast device has a significantly lower risk of early postoperative complications in a community clinic, especially migration/impaction of the ring when compared to the standard Plastibell device.

Circumplast device size

Circumplast device are available in four different sizes (9.5, 11, 12, and 13) which is equivalent to Plastibell sizes 1.2, 1.3, 1.4 and 1.5. Boxes and individual items are colour coded with green (size 9.5), red (size 11), orange (size 12) and dark blue (size 13). 

Experience of 112 cases of Circumplast circumcsion presented in the 26th Congress of the European Society for Paediatric Urology, Prague 14-17 October 2015

Our expert surgeon presented Circumplast experience of 112 cases to the 26th Congress of the European Society for Paediatric Urology. This was a joint meeting with Society for Paediatric Urology, American Association of Pediatric Urologists, American Academy of Pediatrics/Section on Urology, Society for Fetal Urology and International Children’s Continence Society. This was one of the largest gatherings of paediatric urologists from across all continents providing an exciting experience at Prague, Czech Repulic on 14-17 October 2015.

CIRCUMCISION WITH A NOVEL DISPOSABLE RING

CIRCUMPLAST®. DOES THIS NEW DESIGN PREVENT RING MIGRATION AND GLANS PENIS INCARCERATION?

Circumplast® was used to perform non-therapeutic circumcisions on 112 male children between April 2013 and March 2014. The procedures were performed at a community clinic under local anaesthesia by the trained paediatric surgeon

Average age of patients was 2.9 years (range, 7 days to 11 years) and median age was 5 months. Patients (n=111) had spontaneous ring separation. Delayed separation of the ring in a 9 year old patient required ring removal as the ring had not come off on day 15 post-operatively due to inadequate size of ring when compared to glans penis. Using the Plastibell® method on 1883 patients over a one year period resulted in delayed/partial ring separation or proximal migration in 2.1% (n=40) of patients. Due to Circumplast’s® cylindrical design, there is no risk associated with the glans moving distally as there are no obstructions. In contrast, the Plastibell™ ring is conical with a narrowed distal end and the glans is held against the distal opening which causes the glans to protrude through this opening. Circumplast allows for multiple locations to secure the ligature and easy access to the glans and frenulum postoperatively.

The Circumplast® device with a cylindrical design virtually eliminates the risk of migration/impaction of the ring to the shaft of the penis in our experience of 112 circumcisions.