The disposable circumcision stapler is a solution for patients seeking a quick, reproducible, and minimally invasive procedure. For patients undergoing circumcision, two things matter most: pain and cosmetic outcome. A randomized study published in the Asian Journal of Andrology investigated how the disposable circumcision stapler (DCSD) compares to the conventional method and the Shang ring — in a group of 942 men.
Methodology: 942 patients, 3 methods, 5 centers
A prospective, randomized study included 942 men (mean age 31.5 years) treated in five hospitals between 2012 and 2013. They were equally divided into three groups of 314 people:
- conventional circumcision (electrosurgical knife, absorbable suture, 2% lidocaine block),
- Shang ring,
- disposable stapler (DCSD) — with 5% lidocaine cream anesthesia (no injection).
Procedure time, blood loss, healing time, intra- and postoperative pain, complications, and patient satisfaction were compared.
Results: The stapler wins across the board
| Parameter | Conventional | Shang Ring | Stapler (DCSD) |
|---|---|---|---|
| Procedure time | 21.4 min | 5.9 min | 7.6 min |
| Blood Loss | 16.5 ml | 3.0 ml | 3.8 ml |
| Healing time | 23.6 days | 19.5 days | 15.5 days |
| Intraoperative Pain (VAS) | 6,2 | 5,8 | 1,9 |
| Postoperative Pain (VAS) | 3,3 | 6,4 | 2,7 |
| Overall Satisfaction | 47,1% | 50,0% | 78,7% |
The stapler provided the shortest healing time and lowest pain — significantly lower than both other methods (p<0.001).
Key difference: cream anesthesia instead of injection
In the stapler group, 5% lidocaine cream was applied to the penile surface — instead of a painful injection block. The effect: intraoperative pain of only 1.9/10 compared to 6.2 with the conventional method. Avoiding injections also eliminates the risk of hematoma and post-injection complications.
Fewer complications
| Complication | Conventional | Shang Ring | Stapler (DCSD) |
|---|---|---|---|
| Wound infection | 2,6% | 4,1% | 0% |
| Wound dehiscence | 4,5% | 5,1% | 3,2% |
| Edema | 21,3% | 18,5% | 1,9% |
| Hematoma | 5,1% | 0% | 3,2% |
Most notably, edema decreased from 21.3% to 1.9%, and there was a zero infection rate in the stapler group.
Highest patient satisfaction
80.6% of patients reported satisfaction with the appearance of the penis after stapler use — compared to only 20.1% after the conventional method. Overall satisfaction was 78.7% (stapler) vs 47.1% (conventional). The authors attribute this to the even, symmetrical cut and fewer scars.
Limitations – Honestly
In 10 out of 314 patients in the stapler group, wound dehiscence occurred (managed with absorbable sutures), and some experienced delayed staple shedding and isolated hematomas. The authors indicate these issues as areas for further device improvement.
Anastomat ZSR 2.0 in light of this data
The Anastomat ZSR 2.0 belongs to the class of disposable circumcision staplers (DCSD) — precisely the type evaluated in this study. Subsequent generations develop the confirmed advantages: short procedure time, minimal pain, topical anesthesia, and reproducible cosmetic outcome.
View Anastomat ZSR 2.0 specifications → | Schedule a consultation →
Conclusions
In a study of 942 patients, the disposable circumcision stapler provided the lowest pain, shortest healing time, and highest satisfaction among the three methods compared — with a zero infection rate. Combined with cream anesthesia, it offers a minimally invasive, reproducible, and comfortable alternative to classical surgery.
Source: Lv BD, Zhang SG, Zhu XW, et al. Disposable circumcision suture device: clinical effect and patient satisfaction. Asian J Androl. 2014;16(3):453–456.
Content intended for medical professionals; does not replace individual clinical assessment.
Sources
- Lv BD, Zhang SG, Zhu XW, Zhang J, Chen G, Chen MF, Shen HL, Pei ZJ, Chen ZD. Disposable circumcision suture device: clinical effect and patient satisfaction. Asian J Androl. 2014;16(3):453–456. doi:10.4103/1008-682X.127816. PMID: 24759586. View in PubMed
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