Laser Circumcision

A. Miranda, F. Silva

Circumcision, Postectomy, Phimosis, Carbon-dioxide laser

Circumcision is considered a simple surgical procedure; however, an overall complication risk of 3.8% has been reported.1 Bleeding, pain and non-satisfying cosmetic appearance are some of common described complications, most of which may significantly impact on patient’s quality of life.1 The CO₂ laser circumcision showed better outcome, when compared with standard circumcision, with shorter operative time, less blood loss, lower postoperative complication rate, less wound irritation and better cosmetic appearance.2,3

This video provides a detailed step-by-step demonstration of circumcision utilizing the CO₂ laser. The technique involves a continuous CO₂ laser beam, which allows for controlled resection and effective hemostasis. The CO₂ laser device used was the SmartXide (DEKA, Florence, Italy), with output setup to 5W power in continuous mode.

This video illustrates each step in detail, from anesthesia to the application of the laser, tissue resection and suturing. We discuss the procedural nuances to help practitioners understand the use of the CO₂ laser for male circumcision, with emphasis on patient safety, efficiency, and aesthetic outcome.

1. Rosato E, Miano R, Germani S, Asimakopoulos AD. Phimosis in Adults: Narrative Review of the New Available Devices and the Standard Treatments. Clin Pract. Feb 18 2024;14(1):361-376.

2. Ronchi P, Manno S, Dell'Atti L. Technology Meets Tradition: CO(2) Laser Circumcision versus Conventional Surgical Technique. Res Rep Urol. 2020;12:255-260.

3. Xu Y, Li F, Li Z, et al. A prospective, randomized controlled trial of circumcision in adult males using the CO2 laser: modified technique compared with the conventional dorsal-slit technique. Photomed Laser Surg. Sep 2013;31(9):422-7.