A blunt-edged probe is used to separate the glans from the preputial lining, taking care not to traumatize the frenulum.

The prepuce is lifted in an upward and outward direction by the hemostat. This action causes the glans to retract towards the scrotum, preventing accidental amputation of the glans. The open jaws of the Mogen clamp are placed around the prepuce (grooved side facing the glans) as it is lifted upward (Figure 1a). The clamp is closed for one to one and one-half minutes. If the infant is more than six months old, the clamp should remain closed for five minutes. While the clamp is closed, the prepuce is excised distal to the clamp (Figure 1b).

The clamp is then opened slowly and removed. Downward pressure is applied to the preputial skin around the corona, until the skin-mucosal seal is broken and the glans is liberated (Figure 1c). A blunt probe is used to remove any additional adhesions. Petrolatum gauze is applied to cover the operative site. The preputial skin around the corona of the glans will often have a "dog-eared" or asymmetric appearance. As the infant grows, this aspect becomes less prominent.

Figure 1a.
Placement of the Mogen clamp

Figure 1b.
While the Mogen clam remains closed,
the prepuce is excised distal to the clamp.

Figure 1c.
Appearance of circumcision
with the Mogen clamp.