What cutting instrument is recommended for circumcision due to less trauma to end vessels?

The recommended cutting instrument for circumcision that causes less trauma to end vessels is bipolar diathermy. This method utilizes a high-frequency electrical current to cut tissue and simultaneously coagulate (seal) surrounding blood vessels. The coagulation effect minimizes bleeding and trauma, which is particularly important in delicate areas such as the foreskin where numerous end vessels are present.

Using bipolar diathermy helps to achieve a clean incision with reduced risk of excessive bleeding, as it allows for precise control over the amount of thermal energy used and effectively seals vessels as they are cut. This is advantageous in pediatric patients, where minimizing trauma and ensuring a quick recovery are priorities.

While scalpels are traditional cutting instruments and can provide a sharp, clean cut, they do not offer the hemostatic benefits that bipolar diathermy does. Electrocautery also uses heat but can potentially lead to more tissue damage and thermal injury compared to bipolar diathermy, particularly because it generally involves applying heat through a single electrode. Lasers can be effective but often require specialized equipment and training, and their use can vary depending on the specific clinical situation. Therefore, bipolar diathermy is often favored in circumcision procedures for its efficiency and safety in managing bleeding.