Comparative Study on Stapler Circumcision vs. Dorsal Slit: Outcomes, Complications, and Efficiency

Abstract

Introduction: Circumcision is one of the most commonly performed surgical procedures globally, with indications ranging from medical to cultural. The stapler circumcision technique, employing a circular stapling device, is a novel approach lauded for its speed, reduced bleeding, and improved cosmetic outcomes. Conversely, the dorsal slit method, a traditional surgical technique, is cost-effective but associated with higher postoperative discomfort and longer operative times. This study aimed to compare the clinical outcomes, safety, and feasibility of stapler circumcision versus the dorsal slit technique.
Methods: This randomized controlled trial included 200 male patients aged 18–60 years, randomized into stapler (n = 100) and dorsal slit (n = 100) groups. Procedures were conducted under local anesthesia by experienced surgeons. Primary outcomes included healing time, postoperative complications, and operative time, while secondary outcomes assessed pain scores and cosmetic satisfaction using validated scales (VAS and POSAS). Statistical analyses included t-tests and chi-square tests, with p < 0.05 considered significant.
Results: Stapler circumcision demonstrated significantly shorter operative time (7.8 ± 1.2 vs. 15.6 ± 2.1 minutes, p < 0.001) and faster healing (12.4 ± 2.3 vs. 16.8 ± 3.1 days, p < 0.001). Pain scores were lower at all intervals (6, 24, and 48 hours, p < 0.001). Complication rates were reduced in the stapler group, with lower incidences of bleeding (3% vs. 10%, p = 0.02), infection (5% vs. 12%, p = 0.04), and edema (7% vs. 15%, p = 0.03). Cosmetic satisfaction was higher in the stapler group (POSAS score: 9.1 ± 0.8 vs. 7.5 ± 1.2, p < 0.001).
Conclusion: Stapler circumcision offers superior clinical outcomes, including reduced operative time, faster healing, and improved cosmetic results, compared to the dorsal slit method. Its advantages make it a valuable choice in modern circumcision practices, despite higher upfront costs. Further research on cost-effectiveness and long-term outcomes is warranted.