Circumcision Procedures: How does a Sleeve Resection work?

Male circumcision is arguably the oldest and safest surgical procedure in history and is usually performed in hospitals or circumcision clinics.

However, some reasons why males undergo circumcision is because of cultural or religious reasons. For example, Jews and Muslims practice religious circumcision, while cultural circumcision is prevalent in Africans, Australian aborigines, and other ethnic groups worldwide.

Circumcision is a surgical procedure that removes the foreskin from the glans penis. The procedure is typically painless because it’s done with anesthesia or numbing cream. Doctors can perform several types of circumcision on males of all ages.

There are different methods of circumcision; one of the most common types of circumcision is the sleeve resection method.

What is the Sleeve Resection Method?

The sleeve resection method is a freehand method appropriate for infants, young boys, and adults. Although, it’s more suitable for young boys and adult circumcision as it provides better cosmetic results than forceps-guided or dorsal slit circumcision.

The procedure involves creating incisions with a scalpel in both the outer and the mucosal surfaces of the foreskin. It removes the foreskin while leaving the inner lining of the foreskin intact. This type of circumcision preserves the sensual function of the penis and allows for natural erections.

Step-by-Step Sleeve Resection Procedure

A sleeve resection requires a highly skilled surgeon and is carried out under a local anesthetic. Here’s how the doctor will proceed with this type of circumcision:

  1. The doctor will clean the penis and administer anesthesia.
  2. The prepuce is slid back over the glans penis, and the doctor makes a freehand cut around the shaft where they will place the scar line.
  3. Then, the doctor returns the foreskin to cover the glans and makes another circumferential incision around the shaft at the same position as the first cut.
  4. The doctor will make a longitudinal incision between the two circumferential cuts and the strip of skin removed.
  5. If there is any bleeding during the circumcision procedure, the doctor will stop it by using Bipolar Diathermy or electrocautery.
  6. The free raw edges are then pulled together and sutured.
  7. The frenulum, or the underside of the penis, can be included in the main cutting or cut separately if desired.
  8. Finally, the doctor will end the procedure by covering the wound with a Jelonet (a gauze lubricated with petroleum jelly) and a clean gauze on top.

After the Circumcision Procedure

Once the doctor completes the circumcision procedure, it’s normal for the area to be swollen and bruised. The doctor will give you specific instructions on cleaning and caring for your penis as it heals. It’s essential to keep the area clean and dry to prevent infection.

You should also avoid the following for at least 4 weeks:

● Sexual activity

● Tight clothing

● Strenuous exercise

The healing process takes about 6 weeks, and you should schedule a follow-up appointment at the circumcision clinic to ensure that the circumcision site is healing properly. See more aftercare tips here.

Advantages of Sleeve Resection Method

There are several advantages of the sleeve resection method.

● The incision is made on the side of the penis, not the top. This provides for a better cosmetic outcome and allows for faster healing.

● There is less blood loss as compared to other circumcision methods.

● There’s no need for excess skin removal, which helps to preserve penile length.

Risks of Sleeve Resection Method

Circumcision is a surgical procedure, so it’s expected that it also comes with risks. Here are the risks associated with the sleeve resection method:

● It’s a complex procedure compared to other types of circumcision and requires a highly skilled surgeon.

● It’s unsuitable for patients with pre-existing medical conditions like diabetes or hypertension.

● There’s a slight risk of penile injury and infection.

Sleeve Resection vs. Dorsal Slit Circumcision

The dorsal slit type of circumcision is a less complex procedure as compared to the sleeve resection method. It’s also suitable for adult circumcision and provides good cosmetic results. However, dorsal slit circumcision also has a few disadvantages.

● The incision is made on the top side of the penis, which can lead to more blood loss.

● There’s a risk of the foreskin becoming stuck in the wound, which can cause the procedure to be more painful.

● The procedure can cause the penis to be shorter.


For patients suffering from phimosis (when you can’t pull the foreskin back over the head of the penis) or paraphimosis (when you can’t return the foreskin to its normal position), the dorsal slit method of circumcision is recommended.

If the doctor uses the sleeve resection method, the phimosis will prevent retraction of the foreskin. This means that the doctor cannot mark the second incision line near the corona. Instead, the doctor should make a small dorsal slit long enough to allow the foreskin to retract.

Once retracted, the doctor can separate any adhesions and remove any debris under the foreskin. Once the doctor removes all the adhesions, only then can he proceed with the sleeve resection method as usual. This means the procedure could take longer than usual.

The Bottom Line

If you’re considering circumcision for yourself or your son, it’s important to consult with a qualified doctor to discuss the risks and benefits of the procedure. The sleeve resection method is a safe and effective way to remove the foreskin while preserving penile length, function, and sensation. However, remember that a highly-skilled surgeon can only perform this type of circumcision to minimize the risks of complications.

At the Center for Circumcision, you can discuss circumcision with our doctors anytime. We’ll be happy to help you make a safe and informed decision and book a free consultation.

Schedule a free consultation with us to learn more about adult circumcision. Contact us today!

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