Minkin: Today, infant circumcisions are done in the hospital, one to two days after birth. They are usually done in the nursery, not in an operating room. To start the procedure, the baby is placed on a circumcision board where the baby's feet are put into little straps – they don't hurt them – it is just to keep the baby from kicking. A lot of times we give the baby some sugar syrup to suck on that is said to relieve pain. And some people give some sort of Novocain to the baby, through a topical anesthetic or local injection anesthetic. The whole procedure, from start to finish, typically only takes ten minutes.
Hittelman: There are several different approaches, and depending on your age, there are different types of procedures that will be performed. In infants, it is typically done with a clamp-like device. It can be done with clamp called a gomco, which is almost like a bell that you put over the glans to protect the glans. You pull the foreskin over the glans and cut around the gomco. Another way is to use a mogen clamp where you pull the foreskin over the glans and then use the clamp to protect the glans while you cut the skin beyond that point. The last approach is where they place a plastic covering, called a plastibell, over the glans and then tie a string around the skin and cut off the residual skin. Then, after time, the string will cause the skin to close and the plastibell will fall off in its own.
When children are beyond the first two months of life, a procedure is done in the operating room under anesthesia where you make two incisions in the skin and remove the sleeve of skin between the two incisions. Sutures are used to hold the skin back together. The procedure on adults will either be done in an operating room or under local anesthetic in the office.