Understanding the Intact Video
This video was taken in the Toronto area in 1998. The circumcision was done with a Gomco clamp and apparently with local anesthetic*, though in Canada today anesthetic is often not used in circumcisions, and in the U.S. the majority of are still carried out without any anesthetic of any kind. There has been no adjustment of the video images or sound, and the full-length version is without editing of any kind, save for the audio removal of the baby's name.
The Gomco Clamp
In order to understand the procedure, it is necessary to have some background: First, the doctor straps the baby down to the circumstaint board and applies betadine solution (http://www.hc-sc.gc.ca/drug2/product/p513.html) as an antiseptic. A drape is placed over the baby to try to maintain a sterile field. A quick check is done to make sure that the babies penis is normal.
The Circumstraint
Because a baby's prepuce is usually naturally adherent to the glans (this is true of both males and females), it must first be torn away in order to perform the circumcision. The doctor applies clamps and inserts the nose of a pliers-like instrument to tear away the foreskin from the glans.
A clamp is used as a probe to separate the foreskin from the glans.
Once this is done, the clamp is used to make a crush line for the dorsal slit. The dorsal slit allows the bell to be placed under the foreskin easily.
The dorsal crush
After the dorsal crush has been applied for long enough to reduce the chance of bleeding, the dorsal slit is made with a scissors inside the crush line.
The dorsal cut has been made
Now the doctor puts the bell of the clamp over the glans and arranges the base plate over the foreskin. Note that the flange of the bell is slightly larger than the beveled hole in the base plate.
Arranging the bell over the glans and the foreskin between the bell and the base plate
He next pulls the foreskin through the space between the bell and the base plate, making sure that the end of the dorsal slit is above the base plate.
The foreskin is pulled through the base plate.
Note that the end of the dorsal slit is above the base plate.
The arm of the bell is now inserted into the yoke and the nut is tightened. When the nut is tightened, the rocker arm will pivot at the notch, pulling on the arm of the bell and crushing the foreskin between the bell and the base plate. Using a scalpel the foreskin is now cut against the bell at the base plate and removed.
The foreskin is cut along the base plate
Now there is a wait to allow the clamp assembly to crush the blood vessels to lessen the chance of bleeding. The clamp is removed. Because of the crush, the remaining skin is stuck to the bell and must be pulled away with the fingertips and gauze.
End result. Note that there is only shaft skin and glans left.
The frenulum and all the inner mucosa including the ridged
band, has been removed
For another explanation of a Gomco Circumcision from American Family Physician click here, and for a description from Patient Care Magazine, March 15, 1978, click here.
*The doctor mentions that anesthetic has been included in the antiseptic solution. However, this does not seem to be a standard way of applying topical anesthetic, and there is some doubt that such an application would have time to take effect. Betadine alone (http://www.hc-sc.gc.ca/drug2/product/p513.html) contains no anesthetic properties.