Frequently Asked Questions

What Age Patients do we see?

Our practice serves a specific age group, newborns up to 28 days old. We specialize in providing circumcision services for male infants within this age range. It's important to note that we do not perform circumcision procedures for children or adults.

What are the Hours of the clinic?

We can be reached 24 hours a day to schedule a visit at (401) 417-0107.  The clinic is staffed every Wed from 9 am –1 pm for prospective families and caregivers to visit our facility and meet our staff.  Procedures are scheduled by appointment.

Where is the SafeCirc Center of Excellence Located?

We are located in southern Rhode Island (148 Main Street, Wakefield, RI, 02879) but take care of patients that come from all over the US and the World. We are 30 minutes from TF Green International Airport, 1.5 hours from Boston, and 3 hours from New York City. See our page on traveling to Rhode Island.

Do Our Providers Offer In-Home Newborn Male Circumcision for Ceremonies or Convenience?

We understand the importance of convenience and personalization for families during such significant moments. Our team frequently performs circumcision procedures in homes, whether as part of a ceremony or to accommodate the newborn and family/caregivers' needs. 

It's important to note that our In-Home service operates on a fee-for-service basis. For inquiries regarding rates or any further questions, please don't hesitate to contact us. We're committed to providing exceptional care tailored to your preferences and convenience.

Can Our Providers Travel Out of State to Perform Newborn Male Circumcision?

Absolutely! Through our specialized In-Home, Out-of-State service, we bring the convenience of circumcision procedures to families like yours, no matter where you're located. Our service is structured on a fee-for-service basis, ensuring clarity and adaptability to suit your needs. If you have questions about rates or any other concerns, feel free to contact us directly. 

Do We use Local Anesthesia?

Yes, we offer and encourage the use of lidocaine applied locally so the procedure can be painless for your newborn.  To provide further comfort we can accommodate breast feeding or the use of breast milk during the procedure and, alternatively, offer sucrose water depending on family and care giver preference.

Does the Clinic Accept Insurance?

We do accept insurance from certain carriers at this time. Please reach out to us for further details regarding coverage.

Why an outpatient clinic?

According to the World Health Organization's (WHO) findings from 2010, newborn male circumcision is predominantly conducted after hospital discharge worldwide. The immediate postpartum period can be overwhelming for parents and caregivers, necessitating flexible options for procedures like circumcision.

In Rhode Island and numerous areas across the United States, newborn circumcision is commonly performed by OB/GYN physicians in hospital settings, with limited follow-up care. This often leaves pediatricians and Family Medicine physicians to manage any complications post-procedure.  Understanding this issue, our clinic offers the convenience of scheduling circumcision after hospital discharge, accommodating the preferences of parents, and ensuring optimal care for their newborns

At our outpatient clinic, we address these concerns by providing comprehensive care, including preoperative assessment, state-of-the-art surgical care, postoperative care, and 24-hour on-call continuous support. As a specialized Center of Excellence exclusively dedicated to newborn male circumcision, we uphold stringent standards in provider training, competency, and care quality, ensuring optimal outcomes for every newborn entrusted to our care.

Who is Dr. Tomlinson?

Dr. Tomlinson is an MIT trained Mechanical Engineer and US Navy trained Family Physician who has spent the last 20 years working to improve newborn male circumcision care.  While stationed in Newport, RI, Dr. Tomlinson developed an improved Gomco clamp that prevents mismatching device parts.

When the World Health Organization concluded that circumcision prevents heterosexual transmission of HIV in 2007 they also asked for a safer device that could be used in resource limited areas.  Dr. Tomlinson assembled a team of experts from around the World, including Dr. Anthony Caldamone, a leading Pediatric Urologist, to solve this problem.  The result of this effort is the Minimally Invasive AccuCirc® device and now the SafeCirc® Center of Excellence.

Dr. Tomlinson is a Clinical Assistant Professor in the Department of Family Medicine and has been a consultant to the WHO, NIH, and Gates Foundation and developed newborn male circumcision training programs in Nigeria, Botswana, Zimbabwe, South Africa, and Kenya.  Dr. Tomlinson has been a staff physician at South County Hospital since 2007 and was named Physician of the Year and awarded the degree of Fellow from the American Academy of Family Physicians in 2015.

What is the AccuCirc?

The Minimally Invasive AccuCirc® sets a new standard in male circumcision with its foreskin holder. This FDA-cleared, revolutionary improvement ensures precise tissue removal by applying gentle pressure to hold the foreskin in place. By aligning the foreskin accurately before incision, providers reduce the risk of tissue discrepancies. To fully understand the device please see our animated videos here. To fully understand the device please see our animated videos here.

Has the AccuCirc Been Clinically Tested?

Yes, extensively.  The first clinical trial was conducted at Hasbro Children’s Hospital under the direction of Dr. Anthony Caldamone.  Because of the importance of male circumcision in preventing HIV, the NIH and Gates Foundation sponsored two randomized controlled trials and two large field trials.  These studies led to several publications, FDA clearance, and WHO prequalification, please see the section on the history of the AccuCirc® for detailed references here.

Why Do We Use a Surgical Pen?

Pediatric urologists have been advocating the use of a surgical pen to mark the site of the incision to avoid errors in removing too much or too little tissue.  In 1983, George Kaplan published a comprehensive review of the complications of newborn male circumcision and made the following recommendation: “Prevention of these errors is best achieved by marking the site of the corona on the skin surface prior to any incision.”

 The use of a surgical pen is mandatory in our clinic!

Why Do We Use Bipolar Electrosurgery to Control Hemostasis?

Bipolar electrosurgery emerges as a superior option for achieving effective hemostasis while minimizing complications compared to traditional silver nitrate and alternative methods. Our practice exclusively utilizes bipolar instruments recognized for their safety and efficacy in newborn male circumcision procedures.

Why Do We Use Tissue Adhesive?

Pediatric urologists have been using tissue adhesive for infant male circumcision for many years.  One of the more common complications of newborn male circumcision is adhesion formation.  Tissue adhesive helps seal and protect the wound and helps prevent the wound from healing the wrong way.  Tissue adhesive also helps reduce bleeding and makes caring for the wound easier for the parents/caregivers.

I am a provider and I preassemble the parts of a Gomco, so why would I ever mismatch parts?

Dr. Tomlinson felt the same way, but during the Iraq War when many Navy providers were deployed and the few that remained were woefully understaffed, he was performing a circumcision after a night on call on the labor deck when he could not get a 1.3 cm shield to fit in his newborn patient.  In the middle of the procedure, he asked the nurse to get a 1.1 cm device and easily placed a 1.1 cm shield, but then had two clamps of different sizes on the field.  He chose the 1.3 cm clamp (the wrong one), the bell/shield fit in the yolk, the mistake was hidden by the foreskin, the nut tightened against the base plate, further creating the illusion that everything was OK.  The small shield passed through the larger hole, no crush was made, and there was no protection for the glans.  Thankfully this patient was not injured, but this is how these complications occur despite the best effort of the provider.

The Minimally Invasive AccuCirc® is an engineering solution to this problem.  The device itself is engineered to prevent mismatching device parts, no matter what, protecting the provider and patient from this mistake and resulting injury.

Why Not Use a Mogen clamp?

Over the past 15 years, Dr. Tomlinson has lent his expertise as an expert witness in 20 medical malpractice cases, all related to Mogen clamps and distal tip penile amputations. Witnessing the profound impact of this complication on patients, families, healthcare facilities, and providers, he emphasizes its devastating nature. Regardless of the provider's experience level, this injury can occur, with even higher incidence rates noted outside the US. This devastating complication, which only occurs with this specific circumcision device called a Mogen clamp occurs and is reported every year in the US by the FDA. We will never use this clamp in our center.  Ensuring newborn safety, the SafeCirc® Center of Excellence offers parents and caregivers a safer alternative.

References to Mogen Clamp Injuries:

https://pubmed.ncbi.nlm.nih.gov/34486279/

https://pubmed.ncbi.nlm.nih.gov/8657537/

https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/detail.cfm?mdrfoi__id=17333882&pc=HFX