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In our experience patients undergoing circumcision are mostly concerned about pain and penile appearances. We conducted a prospective randomized trial to assess the benefits of a new disposable circumcision suture device （DCSD）. A total of 942 patients were equally divided into three groups （conventional circumcision, Shang ring and disposable suture device group）. Patients in the DCSD group were anesthetized with compound 5% lidocaine cream, the others with a 2% lidocaine penile block. Operation time, intra-operative blood loss, incision healing time, intra-operative and post-operative pain, the penile appearance and overall satisfaction degree were measured. Operation time and intra-operative blood loss were significantly lower in the Shang ring and suture device groups compared to the conventional group （P 〈 0.001）. Intra-operative pain was less in the suture device group compared With the other two groups （P 〈 0.001）; whereas post-operative pain was higher in the conventional group compared to the other two groups （P 〈 0.001）. Patients in the suture device （80.57%） and Shang ring （73,57%） groups were more satisfied with penile appearances compared with the conventional circumcision group （20.06%, P 〈 0.05）. Patients in suture device group also healed markedly faster than the conventional group （P 〈 0.01）. The overall satisfaction rate was better in the suture device group （78.66%） compared with the conventional （47.13%） and Shang ring （50.00%） groups （P 〈 0.05）. The combination of DCSD and lidocaine cream resulted in shorter operation and incision healing times, reduced intra-operative and post-operative pain and improved patient satisfaction with the cosmetic appearances.

This systematic review assessed the safety and efficacy of the disposable circumcision suture device （DCSD） and conventional circumcision （CC） in the treatment of redundant prepuce and phimosis. Two independent reviewers conducted a literature search for randomized controlled trials （RCTs） using the DCSD and CC for the treatment of redundant prepuce or phimosis in China and abroad. Nine RCTs （1898 cases） were included. Compared with the CC group, the DCSD group had a shorter operative time （standardized mean difference [SMD] = -21.44; 95% confidence intervals [95% CIs] [-25.08, -17.79]; P 〈 0.00001）, shorter wound healing time （SMD = -3.66; 95% CI [-5.46, -1.85]; P 〈 0.0001）, less intraoperative blood loss （SMD = -9.64; 95% CI [-11.37, -7.90]; P 〈 0.00001）, better cosmetic penile appearance （odds ratio [OR] =8.77; 95% CI [5.90, 13.02]; P 〈 0.00001）, lower intraoperative pain score, lower 24-h postoperative pain score, lower incidence of infection, less incision edema, and fewer adverse events. There were no differences between the CC and DCSD groups in the incidences of dehiscence, or hematoma. The results of this meta-analysis indicate that the DCSD appears to be safer and more effective than CC. However, additional high-quality RCTs with larger study populations are needed.

Objective To explore the therapeutic effect of using Fast Fix suture device combined with suture hook technique by arthroscopy to all-inside suture the tear of the lateral meniscus within the popliteal hiatus area. Method Seventy-two patients with the tear of the lateral meniscus within the popliteal hiatus area were selected and divided into three groups: a Combined Group ( n  = 24) treated with Fast Fix and suture hook, a Fast-Fix Group ( n  = 24), and a Suture Hook Group ( n  = 24). All patients had longitudinal tears located in the red and red-white zone. All patients received arthroscopic all-inside suture in the red and red-white zones of the meniscus with no complex tears or defects. Knee function was evaluated preoperatively and postoperatively using the Lysholm score and knee flexion-extension range of motion (ROM). MRI images were collected at least six months post-operation to assess meniscus healing. Follow-up was conducted at 3, 6, and 12 months, with no major complications such as infection or secondary trauma, and good patient compliance. Result At 6 months and 12 months post-operation, the patients in the Combined Group showed significant improvements in both Lysholm scores and ROM ( P  < 0.05), demonstrating the positive therapeutic effects of the combined treatment. The Lysholm score increased from 53.71 ± 11.37 points preoperatively to 70.63 ± 8.47 points at 6 months ( P  < 0.05) and 81.04 ± 13.08 points at 12 months ( P  < 0.05). The ROM improved from 103.58° ± 10.75° preoperatively to 123° ± 9.15° at 6 months ( P  < 0.05) and 125.13° ± 7.49° at 12 months ( P  < 0.05). MRI results confirmed good healing of the meniscus after more than six months, further supporting the effectiveness of the procedure. Compared with the other two surgical technique, the combined technique yielded significantly better functional recovery and structural healing than either technique alone ( P  < 0.05). Conclusion The combination of the Fast Fix meniscus suturing device and suture hook technology provides a safe, stable, and effective method for the arthroscopic repair of lateral meniscus tears. This technique demonstrates significant clinical benefits in terms of knee function recovery, meniscus healing, and patient satisfaction. We recommend wider clinical adoption of this combined technique for improved outcomes in meniscus repair.

Purpose We compared the magnetic resonance imaging (MRI)-confirmed cyst formation rate after meniscal tear repair using a new all-inside suture device (N group) versus the older all-inside suture device (O group). Methods Between October 2008 and July 2017, 94 consecutive menisci of 89 patients were diagnosed with meniscal tears and underwent arthroscopic meniscal repair using the all-inside suture device. Five of these patients were lost to follow-up within 12 months and were excluded from the study. The remaining 89 menisci were followed up for at least 12 months and were included in this retrospective cohort study. Older all-inside suture devices (FasT-Fix, Ultra FasT-Fix) were used until December 2012, while the new all-inside suture device (FasT-Fix 360) was used from January 2013 onwards. Meniscal cysts were detected on T2-weighted fat-suppressed MRI at 12 months postoperatively. Multiple logistic regression analysis was used to identify demographic and clinical factors associated with the use of the new all-inside suture device and cyst formation. Results In total, 36 and 53 menisci were included in the N and O groups, respectively. The incidence of meniscal cysts was significantly greater in the O group (14 out of 53, 26.4%) than in the N group (two out of 36, 5.56%) ( P  = 0.012). Two patients in the O group had symptomatic cysts that required removal. Multivariate logistic analyses showed that the cyst formation risk significantly decreased after using the new all-inside suture device than the older all-inside suture devices (odds ratio = 0.139; P  = 0.04). Conclusions The MRI-confirmed cyst formation rate after meniscal tear repair was significantly lower using the new than the older all-inside suture devices, indicating that the use of a low-profile device may decrease the cyst formation rate.

To evaluate the efficacy of frenulum protection technique of the disposable circumcision suture device (DCSD) in adult males. Atotal of 53 adult males were diagnosed with redundant prepuce and underwent circumcision with DCSD using frenulum protection technique. The main preoperative and postoperative measure of the length of penile frenulum was evaluated. Other data such as edema rate, intraoperative blood loss, operation time, postoperative pain, staple falling off time, incision infection rate, and evaluation of satisfaction rate with penis appearance were documented in the study. There was no significant difference in preoperative and postoperative frenulum length for each patient. The mean length of the penile frenulum before and after surgery was 2.25 ± 0.36 cm and 2.23 ± 0.39 cm, respectively (p = .31). The rate of frenulum length preservation was 100%. All the patients had no excessive resection of the frenulum and no serious complication happened after surgery. The satisfaction rate of postoperative penis appearance from patients' evaluation was 98.1% (52/53). The frenulum protection technique was simple and operable, which could help the operator to accurately identify the most distal position of the frenulum and retain a sufficient length of frenulum during DCSD circumcision.

Objectives Endoscopic closures of mucosal defects following endoscopic resection can be challenging and time‐consuming. The novel through‐the‐scope suture device has demonstrated acceptable closure times, but its learning curve is still unknown. This study aims to evaluate the number of cases required to achieve competency in this device. Methods Two endoscopists participated; a novice with less than 400 experiences in upper gastrointestinal endoscopy and an expert with over 500 experiences in endoscopic submucosal dissection. Neither endoscopist had previous exposure to the device. In four porcine models, 24 gastric mucosal defects, each 2–4 cm in diameter, were created by endoscopic mucosal resection with ligation. Each endoscopist performed endoscopic closure for 12 mucosal defects with a single through‐the‐scope suture device per lesion. The primary endpoint was the number of cases needed to reach competency, defined as achieving a procedure time below the average closure time reported in the literature. Secondary endpoints included procedure time, complete closure success rates, and incidence of adverse events. Results The mean defect size was 2.9 (±0.2) cm. Competency was achieved after six cases in the expert and seven cases in the novice. The median closure time was 9.0 (interquartile range [IQR]: 6.0–11.0) min for the expert and 8.0 (IQR: 6.2–9.7) min for the novice (p = 0.862). Complete closure success rates were 75.0% (n = 9) for the expert and 83.3% (n = 10) for the novice. No adverse events were reported. Conclusions A small number of cases were required for both expert and novice endoscopists to reach competency in the novel through‐the‐scope suture device.

Background This study aimed to evaluate the analgesic efficacy and safety of rectally administered diclofenac sodium suppositories during the perioperative period of pediatric circumcision using a disposable circumcision suture device (DCSD), and to provide guidance on their safe and effective use in pediatric practice. Methods In this prospective randomized controlled trial, 140 boys aged 7–12 years undergoing DCSD circumcision were randomly assigned to either the experimental group ( n  = 70; rectal diclofenac sodium, 1 mg/kg) or the control group ( n  = 70; oral ibuprofen, 10 mg/kg). All patients received local penile root block anesthesia with lidocaine. Pain was assessed using the Visual Analog Scale (VAS) by trained nurses blinded to group allocation, with parental assistance to minimize bias. Rescue analgesia use, adverse events, and postoperative sleep quality were also recorded. Results Reductions in VAS scores at scheduled time points did not differ significantly between groups, indicating comparable short-term analgesic efficacy. However, the diclofenac group required fewer rescue interventions, experienced a lower incidence of adverse events (10.0% vs. 30.0%), and demonstrated better postoperative sleep quality. Administration before dressing changes also improved patient cooperation. Conclusion Rectal diclofenac sodium suppositories are an effective and well-tolerated option for perioperative analgesia in pediatric circumcision using DCSD, providing improved comfort, sleep quality, and caregiver satisfaction compared to oral ibuprofen. However, due to the study’s single-center design, short follow-up period, and the use of different NSAIDs between groups, the results should be interpreted with caution. Larger multicenter trials are necessary to confirm these findings and inform broader clinical application. Trial registration (TCTR20250513005) [Registered on 13/05/2025]. This trial is registered with the Thailand Clinical Trials Registry https//www.thaiclinicaltrials.org/.

Purpose Suture button devices for tibiofibular syndesmosis injuries provide semirigid dynamic stabilization, but complications including knot irritation have been reported. No randomized trials of the new knotless suture button devices have been performed. We hypothesized that knotless suture button devices eliminate knot irritation and facilitate quicker return to sports. This study was performed to compare the clinical outcomes, complication rates, and time to return to sports between a new knotless suture button device and syndesmotic screw fixation. Methods This study included 54 patients treated for ankle syndesmotic injury from 2012 to 2014 with a knotless suture button device or syndesmotic screw fixation. Clinical outcomes were measured using the American Orthopaedics Foot and Ankle Society score, Foot and Ankle Disability Index, Olerud and Molander score, and visual analog scale for pain and function. Secondary outcome measures were the complication rate and time required to return to sports. Patients underwent clinical and radiological evaluations preoperatively and three times during the 1-year postoperative follow-up. Results 54 of 62 eligible patients were analyzed, median age 37 (18–60) and underwent the 1-year follow-up. The screw fixation and knotless suture button groups comprised 26 and 28 patients, respectively. The complication rate was significantly lower ( p  = 0.03) and time to return to sports was significantly shorter in the knotless suture button than screw fixation group (average, 14 versus 19 weeks, respectively; p  = 0.006). No significant differences were identified in clinical outcomes or visual analog scale scores for pain and function between the groups. Age, injury mechanism, and body mass index did not significantly affect the time required to return to sports activities. The type of fixation was the only independent variable that reached statistical significance ( p  = 0.006). Conclusion Syndesmotic screw fixation and the new knotless suture button device both resulted in good clinical results. Lower complication rate and the earlier time to return to sports make the new knotless suture button device recommendable especially for highly active patients. Level of evidence Randomized controlled trial, Level I.

Purpose To compare the surgical effects and postoperative complications and patient experience of two circumcision methods (novel disposable suture device and conventional suture approach) in Chinese excess foreskin or phimosis patients performed in our Andrology centre in a prospective non-randomized controlled study. Methods A total of 520 cases of excess foreskin and 62 phimosis patients that underwent circumcision between June 2014 and June 2015 in a single center using novel disposable device ( n  = 295; mean age 30.4 years, range 18–44 years) and conventional suture approach ( n  = 287; mean age 28.6 years, range 16–41 years) were documented. The main surgical outcomes (surgical time, intraoperative blood loss, incision healing time) and postoperative complications and patient experience (postoperative pain score, satisfaction rate of postoperative penile cosmetic appearance, recovery duration) were collected and analyzed. A multivariate logistic regression with likelihood ratio test was also used to observe the possible determinants of edema occurrence postoperatively. Results The novel disposable suture device group had shorter operation time, lower pain score and rapid recovery and a higher satisfaction rate of penile cosmetic appearance when compared to the conventional circumcision group. Besides, the incidence of complications (hematoma and incision bleeding and infection) was significantly lower in the novel disposable suture device group. A multivariate logistic regression with likelihood ratio test revealed that phimosis was the significant predictor of edema occurrence postoperatively (Chi square of likelihood ratio = 9.88, df  = 1, p  = 0.025). Conclusions Circumcision using this novel disposable suture device is associated with short operative time, rapid recovery, less pain experience, less complications (hematoma and incision bleeding and infection) and high satisfaction rate of penile appearance. This new approach should be of value for future application. Phimosis patients should be notified that they had a great possibility to develop edema postoperatively regardless of the surgical options.

To compare the clinical effects of three methods of circumcision: modified circumcision, traditional circumcision, and disposable suturing device circumcision. Male patients (n = 241) with redundant prepuce and/or phimosis were included in a clinical trial from January 2019 to March 2020. Patients were divided into 3 groups based on the surgical method: group A, traditional circumcision (n = 79); group B, modified circumcision (n = 80); and group C, disposable suturing device circumcision (n = 82). The operation times in groups A, B, and C were 25.2 ± 3.3 min, 10.2 ± 2.7 min, and 6.7 ± 1.4 min, respectively. The volumes of intraoperative blood loss in groups A, B, and C were 12.7 ± 2.3 mL, 8.1 ± 3.4 mL, and 2.2 ± 0.8 mL, respectively (P < 0.05). Groups A and B were superior to group C in terms of the 6-h postoperative visual analog scale score and appearance satisfaction (P < 0.05). There were no obvious differences in the 7-day postoperative pain score and total healing time (P > 0.05). The operating expenses in groups A and B were lower than that in group C (P < 0.05). Modified circumcision, with its advantages of shorter operation time, less blood loss and pain, lower cost, and better postoperative penile appearance, is easily accepted by patients and deserves wide clinical application.