ZSR Circumcision

Comparison between traditional surgery approaches and circumcision

	Traditional surgery	Circumcision surgery (various inner + outer caliper)	ZSR disposable circumcision anastomat
Anesthesia required or not	Requred	Requred	Requred
Surgery duration	More than 3O min	More than 15 min	3-5 min
Security	Possiblity of damage	Reletively safe	safe
Hemorrhage during the surgery	A lot	Few	Extremely few almost no
Postoperative pain	Last for 3-4 Days	Last for one week	Painless during the surgery. Slight pain last for 15 min
Hematoncus or not	Common	Occasionally	Rare
Stitches removal after surgery	remove the stitches 10 days after the surgery	Remove the carver one week after the surgery. The incision is prone to cracking after removal of t he caliper.	No removal of stitches requred. The stitches will drop off automaticaly.
Limitation duration	It is prohibited to take movement for two weeks, and sexual for two months.	It prohibited to take movement for MO weeks, and sexual for two months .	It is prohibited to take movement for one week and sexual for one months.
Incision observation	Not flat ! When bleedng again the patients need to go back to the hospital for secondary suturing. Long healing duration required.	Relativety flatter When bleeding again, the patient' need to go back to the hospital for secondary suturing. Long healing duration required.	Very flat Rapid healing
Postoperative nursing	Need to go back to the hospial for several time for dressing nursing.	Need to go back to the hospial for several time for dressing nursing.	Determine to go back to the hospital for dresing nursing or not ten days after the surgery
Acceptability	The adult can easly accept the surgery. However children can hardly accept due to a great amount of anesthesia	It can only applicable to the adult It is can hardly accepted both for the adult and children.	Both the adult and children are easily accept the surgery.
Other influence	The incision can hardly meet the requirements. Occasionally it may cause damage to penis. too mush foreskin frenum resection. .	The incision can hardly meet the requirements. It is easy to cause refection Long duration of swelling and pain	Both penis and foreskin frenum are completely protected by nail base No complications will ocure
Physicians opinion	It is very trouble. long duration. serious hematoma. Pain, not easy to accept	Swelling , angina. Must go back to the hospital one week after the surgery to remove caliper. not easy to accept	Safe, painless, short surgery during. efficient and convenient. It is pleasant to accept the surgery.

Disposable Circumcision Anastomat

• Patented design • Aesthetic and functional • Safe and painless • Standard and efficient • Humanized

Product Introduction :

Disposable circumcision anastomat is a surgical instrument for circumcision and suturing surgery on Male Urology. It is characterized of simple operation, safe and efficient, simultaneous completion of circumcision and suturing. It is a pioneering invention on urologic surgical procedures. Traditional circumcision and suturing surgery approaches have shortcomings such as complicated surgery, long duration, more hemorrhage, painful, rare neat incision, postoperative hematoma. ZSR disposable circumcision anastomat can solve all problems. The product combines clinical medicine experience and simple structure design to enable male urological surgeries be refined, safe, rapid and perfect

A technological innovation, providing patients with more security

Phimosis and redundant prepuce

Clinical interpretation: Both phimosis and redundant prepuce refer to the foreskin covers the whole glans penis. The difference is that redundant prepuce refers to foreskin covers glans penis, thus glans penis can not completely exposed; while phimosis refers to foreskin can’t turn up and down, and the mouth of the foreskin is very small.

Hazards of phimosis and redundant prepuce

Redundant prepuce will hinder penis development and is prone to lead to micropenis.
It is prone to causing urinary system diseases, and inducing acroposthitis, balanitis, urine infection. Long-term inflammation can lead to sexual dysfunction.
The dirt hardened within the foreskin are prone to breeding bacteria, and causing cancer. It is prone to causing secondary prostatitis or even affecting ejaculation, and further leading to infertility.
Can lead to female gynecological diseases such as cervical inflammation, vaginitis after marriage, which will affect quality of sexual life.

Reasons for circumcision surgery

To reduce occurrence probability of penis inflammation and other diseases, and to improve the quality of semen.
To reduce constraints to the penis after redundant prepuce and promote secondary development of penis.
Prolong sexual life duration and improve the quality. Effectively reduce microorganism breeding to make the life more healthy.
Reduce risk factors of reciprocal infection between couple.

Product features

• Patented design – Aesthetic and functional • Safe and painless • Standard and efficient • Humanized

Operating Principle :

The operating principle of anastomat is similar with that of stapler. Through a mechanical driving device, anastomat will be put into a module in advance. After pass through two layers of tissues, the suturing nail of single-use prepuce cutting anastomat will be blacked by the front pin-resisting seat and bent inward to make two layers of tissues nailed together. The suturing nail is made of 316L stainless steel; it has a relative good biocompatibility. As suturing nails are lined up with equal distance and suturing tightness is appropriate, thus, the defects that the manual suture is too sparse or too dense and that the ligation is too tight or too loose can be avoided, which not only guarantees the good healing of tissues, but also largely shortens the operation time.

Safe and Painless

It has been repeatedly clinical validated as safe for operation.
The glans penis is to be protected by a glans penis shielding to avoid being damaged. Adopted high-quality special process treated anastomosis pins.
Adopted professional medical materials for professional sterilization and prevention of infection.
Painless during the surgery and after the surgery. No Impact on penile erection after recovery.

Aesthetic and functional

The product head adopts special process to make the surgery more refine.
Excellent human-machine engineering handle design to make the surgery more convenient.
Incision is smooth and beautiful. And the suturing is uniform.
Automatic dropping of anastomosis pins, not requiring to remove the stitches.

Standard and efficient

Shorter surgery preparation time. Only outpatient surgery is required. The patients can seek for surgery at any time.
Short surgery duration, about 3-5min; high surgery quality.
The patients do not need be hospitalized nor rest in bed. The surgery will not affect your work.

Humanized

Disposable design to avoid cross infection
Sterilization equipment which can reduce surgery preparation time.=Cause lighter edema, less hemorrhage with good recovery effect. It can avoid back to the hospital for multiple times.
Equipped with a variety of calipers with different diameters which are convenient for patients to select the most appropriate diameter.
Simultaneous completion of incision and suturing, which can significantly reduce workload of physicians.

Applicable groups

It is applicable to male patients with phimosis and redundant prepuce.

Application scope

Male genital circumcision
Department of Male Urology.

Contraindication

Man with malformed prepuce or glans (including the person whose prepuce and glans are widely and tightly adhered together)
Man whose prepuce and glens are infected and the person with edema around glans
Man who is suspected to have penile carcinoma
Man who suffers from systematic disease (such as bleeding tendency, hypoproteinemia serious cardiovascular disease, etc.) and mental disease and can’t receive surgery

Instructions :

The operation shall be prepared according to the hospital rules. At first do various examinations to the patient and measure the site of glans with a caliper (the place between the glans and 2/3 of coronary sulcus will be measured: the skilled doctor can make a choke according to experience without a caliper) to select the appropriate single-use prepuce cutting anastomat .Then disinfect the surgical spot and do local anaesthesia. or choose other effective anesthesia ways, For the patient who has adherent prepuce. over short frenum or other congenital anomalies. carry on prepuce cutting and suturing operation after the medical treatment is done and blood is stopped.
Anticlockwise adjust the location adjusting knob at the end of prepuce cutting anastomat and gently take out the concave seat at the front of prepuce cutting anastomat as shown in Figure 1.
Put the concave seat inside the prepuce (If the prepuce is adherent the adhesion shall be stripped. If it is a phimosis, the preputial orifice shall be expanded or cut open with scissors. several small preputial orifices can be cut open to put the concave seat on the glans, but one preputial orifice can be cut too deep and close to coronary sulcus so as to avoid that it exceeds the circumcision part and thus the wound can’t be sutured), and make the prepuce turn out and wrap the outside of concave seat and cover the glans. Make the concave seat tilt and maintain the inclination similar with that of the coronary sulcus, and approperiately leave a bit more frenum so as not to cut the frenum short. The prepuce naturally fits the curve top of concave seal as shown in figure 2.
Gently remove the nail-cabin protective cap used to protect the suturing nails. and slowly insert the screw of well-fixed concave seat into the centre hole at the main body of anastomat. Then, clockwise screw the location adjusting knob to make the plane at the end of screw parallel with the plane at the back of location adjusting knob. The tightness is subject to the specific circumstances of patients. The skilled and experienced doctor can appropriately screw it by feeling, as shown in figure 3.
After adjust the knob in place, make sure if the place where the prepuce will be cut is right or not and if the prepuce is loose or not. After everything is confirmed without any problem, remove the safety pin, as shown in Figure d.
Slowly and horizontally hold the flexible handgrip with strength and trigger the anastomat for about 5 to 10 seconds (at this time, use dry gauze to wrap the operation part to prevent blood leakage as shown In Figure 5.
Loosen the flexible handgrip and assist to reset it Anticlockwise and slowly unscrew the location adjusting knob. After the knob is back out for 5 mm to 7 mm, observe the cutting situation. Press the knob forward and separate the concave seat from the main body of anastomat. Slowly unscrew and back out the anastomat as well as the cut prepuce, and observe if the prepuce is stuck or not If the prepuce is stuck, slightly press it with fingers or scissors, and then the prepuce war be separated naturally. Don’ t aggressively move arms or excessively screw the concave scat to avoid the incision from being torn, as shown in Figure 6.
After remove the instrument check the wound. If the wound is not completely sutured due to carelessness, the wound can be appropriately sutured. The wound shell be smooth and the suture shall be evert as shown in Figure 7.
Disinfect the wound and wrap it with dry gauze, and then dress it with an elastic bandage for 3 to 5 hours. After the operation. the patient shall follow doctor’ s advice, coordinate with postoperative care and use drugs. Before postoperative recovery, avoid over-activity and by best to avoid erection, and it is forbidden to drink alcohol and eat seafood. Within one month after operation it is forbidden to have sexual intercourse. It is as shown in figure 8.

Matters Needing Attention

It is a sterilized product. If the package is broken or the sterilization period is expiry, it shall be forbidden to be used.
This product is for single use: please don’ t repeatedly disinfect it for use.
This product shall be used by qualified doctors to do operation.
Must select the product of appropriate size to do operation; forbid to use the product of improper standard to do operation.
After operation, this product shall be professionally handled as the medical waste: avoid annular cutting knife from hurting others.
Please take appropriate rest under the doctor’ s guidance after operation. Pay attention to the local hygiene and the anti-inflammatory treatment Please follow the doctor s advice to use drugs. It is forbidden to take strenuous exercises to avoid hematoma.
In one week after the wound healing, the suturing nail will slowly fall off. Due to the different physiques, if the suturing nail doesn’t fall off in 3 weeks. the patient shall go back to hospital to remove it manually.
Around the prepuce of high-sensitivity physique, if there are slight inflammations, local edema may appear. At this time, anti-inflammatory and anti-allergic drugs on be used to control that.
Pay attention to hygiene after operation: control and eliminate the factors that may cause infections
Equip products with various models and various apertures to make patient accurately select the most appropriate aperture for patients

Postoperative Cares :

The wound shall be dressed with elastic self-adhesion bandage after operation. The bandaged surgical dressing can also be stitched, which can prevent the bandage from being loose and falling apart The suggestion for the time of binding up wound is 7 to 10 days.
About the postoperative pain, the wound will be slightly painful after the anesthetic effect disappears. But several hours later, the pain will gradually be eased and relieved. If the pain is very serious, the patient can take analgesic drugs to relieve the symptom.
The postoperative edema usually doesn’ t need any measures to be taken. The edema will fade away by itself. If it is serious, the patient shall go to hospital for treatment.
During the wound healing period after the operation, the liquid will ooze from the wound. When there are circumstances like that the wound becomes red, swollen, painful heating. etc. the patient shall go to hospital for treatment to avoid the symptom from becoming more serious.
After operation. if the wound is torn due to accident or strenuous exercise, the patient shall immediately go to hospital for treatment.
After operation. the patient shall pay attention to avoiding strenuous exercise. It will not be affected if the work doesn’ t include lots of activities. One week later, the patient can take a shower. After shower and later everyday, iodophor can be used to disinfect the wound: and then the wound can be simply dressed by patient himself. If the patient suffered from long-term phimosis before operation or he is a child a little erythromycin ointment can be applied on the glans.
In 3 days after operation. the patient shall go back to the hospital for examination and let the doctor to observe the recovery condition to master the situation of patient.
After operation the patient shall maintain the cleanliness of wound and use dilute iodophor to clean up the wound once in the morning and once in the evening, and wear breathable loose trousers and keep the wound dry, and do routine postoperative care to prevent infection.

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