HARTFORD, Conn. — Writing in a recent issue of Pediatrics, Drs. Peter Kurtis and Hema DeSilva of St. Francis Hospital and Medical Center in Hartford conclude what mohelim have known for years: The Mogen circumcision clamp used by ritual circumcisers is a faster, less painful way to perform circumcisions than the Gomco clamp preferred by physicians.
Circumcisions using the Gomco clamp take four to 10 minutes to perform, while circumcisions with the Mogen clamp take one to two minutes.
More than one million baby boys are circumcised in the United States each year.
The two physicians monitored the heart and respiratory rates, oxygen saturation and crying of 48 healthy, full-term infants during circumcisions they performed at St. Francis. The study also looked at the use of local anesthesia during the procedure.
“The most common way, the Gomco, is the most painful way. Most physicians use the Gomco clamp without any anesthesia,” Kurtis said. “It’s much less painful with the Mogen clamp. We’ve used the Mogen clamp on several thousand babies.”
Kurtis pointed to several reasons why physicians may not switch to the Mogen clamp. “There’s a lack of familiarity with the technique, skepticism over how well it works,” he said. “There’s a theoretical concern over if is it safe to do.”
Kurtis said the use of anesthesia for circumcisions was first reported almost 100 years ago, although it wasn’t until the late 1970s that the medical community began to seriously consider using local anesthesia.
Noting that the Mogen clamp is faster and less painful, Kurtis said that when it’s used, “even without anesthesia, more than half of the babies didn’t cry during the procedure.” The pain level during circumcision with the Mogen clamp without anesthesia is comparable to that accompanying the Gomco clamp with anesthesia.
“It’s interesting that the way it’s been done in a traditional bris is clearly the least painful way to do the circumcision,” Kurtis added. “Mohels are so skilled and fast at what they do, they do a very good job of minimizing pain to the baby. They’re looked upon as experts in doing circumcision.”