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Circumcision, meatotomy, meatoplasty, and preputioplasty
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Rachel Harwood, Simon E. Kenny
In severe BXO or phimosis, a dorsal slit may be required in order to retract the prepuce after applying artery forceps as described below. A marker pen is used to mark the position of the external preputial incision by observing the coronal ridge of the glans under the foreskin. Care needs to be taken in ensuring that neither excessive nor insufficient penile shaft skin is removed. Similarly, the inner preputial incision is marked with a marker pen leaving an adequate cuff of inner prepuce below the glans penis. This can be performed after the external skin has been incised.
Neonatal and General paediatric Surgery
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Pathological phimosis rarely occurs before the age of 6 years. The foreskin is scarred and whitish in appearance and the opening is severely narrowed resulting in non-retractability (Fig. 18.80). During micturition there may be ballooning of the foreskin and dribbling may occur after voiding. Following an erection, the narrowed foreskin may remain around the glans, constricting its blood supply and culminate in a paraphimosis. The paraphimosis is an extremely painful swelling of the glans that requires emergency treatment either in reduction of the foreskin or a dorsal slit if reduction is not possible.
Miscellaneous conditions affecting the genitalia
Published in Shiv Shanker Pareek, The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
The main treatment aim is to bring the foreskin back to the normal position by applying local anaesthesia – lidocaine or EMLA (lidocaine 2.5% and prilocaine 2.5%) cream – and manually pulling the foreskin back over the glans. Oral paracetamol or NSAIDs are useful to relieve pain, and sexual intercourse should be avoided for 7 to 10 days. If this treatment is unsuccessful, there is an urgent need to seek further urological advice. A dorsal slit incision or circumcision may be necessary.
Pressure versus volume-controlled ventilation with BASKA mask airway in laparoscopic cholecystectomy: A randomized clinical study
Published in Egyptian Journal of Anaesthesia, 2023
Amani H. Abdel-Wahab, Radwan A. Torky
The Baska mask is one of the third-generation SADs, characterized by a self-sealing silicone variable pressure cuff. It makes an oropharyngeal seal which increases proportionately with increased PAP. Its self-retracting cuff contains a dorsal slit enabled by prepared flaps maintaining it semi-inflated at rest. The mask inflates, increasing the pharyngeal seal during the positive pressure ventilation, and deflates partially to the rest when the pressure is released. It possesses a gastroesophageal reflux drainage system with a wide distal opening in the upper oesophagal part that opens into a built-in sump reservoir on its cuff dorsal side that drains into bilateral suction channels. The oval flexible airway aperture at the distal end ensures the seal patency against the gastric overflow [2].