Gomco Circumcision Clamp

The Gomco circumcision clamp is a metal device that medical practitioners use to perform circumcision, or the removal of the foreskin of the penis. Created in 1934 by Hiram S. Yellen, a physician who studied obstetrics and gynecology, and inventor Aaron A. Goldstein, the Gomco clamp was one of the first and, as of 2025, is the most commonly used circumcision clamp in the United States. To use the Gomco clamp, the medical practitioner first separates the foreskin from the glans, or head, of the penis, then places the foreskin into the clamp. The practitioner tightens the clamp, which crushes a thin, circular ribbon of foreskin, and then cuts off the remaining foreskin above the crushed portion. The Gomco clamp reduces the risk of blood loss, controls the amount of foreskin removed, protects the glans of the penis during circumcision, and allows for a clean surgical cut. By simplifying the surgical procedure of circumcision and reducing the risk of complications, the Gomco clamp helped to institutionalize routine, non-therapeutic infantile circumcision as part of the childbirth process in US hospitals.

Medical Context

The Gomco clamp addressed a perceived medical need in the 1930s, specifically to make circumcision easier and safer to perform. By the early years of the twentieth century, doctors in the US were increasingly performing circumcision as a hygienic measure to aid cleanliness and to prevent diseases later in life, but there was no standard way of performing the procedure. In 1935, A. P. Bertwistle, a surgeon in England, for example, published an article in The Lancet in which he bemoaned the lack of a standardized surgical approach, citing an array of textbooks, each presenting different circumcision techniques. Before the Gomco clamp, doctors relied primarily on simple surgical tools to perform circumcisions. The results varied according to the skill of the surgeon, and complications including bleeding and infections were not uncommon, especially since antibiotics were not yet available.

To address the lack of standardization and risks of circumcision, beginning in the early twentieth century, doctors and inventors began creating and patenting technological devices to assist in the procedure. For example, in 1910, S. L. Kistler, a physician in Los Angeles, California, described a clamp device he invented in the Journal of the American Medical Association. Kistler claimed his patented clamp-type device made the procedure so easy to perform that a person could even circumcise himself. Neither Kistler’s device nor any other patented devices caught on, though. Julian Wan, a physician and researcher who studies pediatric urology, suggests that is because the devices were awkward to use and came with potential for complications, such as bleeding or harming the glans.

From 1932 to 1933, Yellen and Goldstein began working together to develop the Gomco clamp. At the time, Yellen practiced obstetrics and gynecology in Buffalo, New York. Wan reports that, according to family members, he was unhappy with the results of some circumcisions he performed and sought a better method. Goldstein was a local inventor and manufacturer who had created a variety of simple non-medical devices beginning in 1925, including a sterilizing holder for clinical thermometers. He founded his own company, GOMCO, short for Goldstein Manufacturing Company, in 1931. Though how Yellen and Goldstein met is unclear, Wan states that the pair may have known each other through religious or social circles. Goldstein patented the Gomco clamp in 1940.

Components of the Gomco Clamp

The Gomco clamp has four parts, namely, a bell, a base plate, an arm, and a screw nut, and it looks somewhat like a large stapler. The base plate runs the length of the entire device and all three other components rest on top of it. The base plate has a hole at the bottom of it. Goldstein and Yellen designed the top of the bell so that it fits through the hole, while the base of the bell cannot fit through the hole. The arm attaches to the top of the bell, and the screw nut sits at the back of the arm. The bell comes in different sizes, and the practitioner uses the one that best fits the size of the glans. The bell goes over the glans and protects it from the practitioner’s scalpel. The interface of the bell and base plate is where the practitioner cuts the foreskin, while the screw nut is what the practitioner turns to generate the crushing force at the interface of the bell and baseplate.

How the Gomco Clamp Works

Before a practitioner can use the Gomco clamp, they must first separate the foreskin from the head of the penis and retract it completely to expose the entire glans. To do so, the practitioner pulls the foreskin forward until it is taut. Then, they use a tool called a straight clamp to make a crush injury along the length of the foreskin and follow that up by cutting the foreskin down the resulting line with a pair of scissors. The crush injury helps to control bleeding. Next, the practitioner inserts a metal probe between the foreskin and the glans and moves the probe around to break the adhesions attaching the inner layer of the foreskin to the glans. After separating the two surfaces, the practitioner pulls the foreskin back over the glans and prepares to apply the Gomco clamp.

Using the Gomco clamp as an aid in circumcision involves several steps. First, the practitioner places the bell over the glans, then pulls the foreskin over the bell. Commonly, the practitioner will use a safety pin to hold the foreskin in place over the bell by piercing both layers of the foreskin on either side of the bell and closing the pin. Next, the practitioner passes the penis and bell up through the hole in the base plate and attaches the arm of the clamp to the top of the bell. The practitioner then tightens the screw nut, which lifts the arm up, pulling the bell with it. Because the bottom of the bell is larger than the size of the hole in the base plate, the lifting action of the arm exerts a crushing force on the foreskin trapped between the edge of the bell and the base plate. Once the medical professional places and tightens the Gomco clamp, they use a scalpel to slice the foreskin off along the top of the base plate at the interface with the bell. The practitioner leaves the tightened clamp on for three to five minutes so that blood clotting occurs. The practitioner then releases the clamp.

At the crush site, the Gomco clamp produces a very thin, ribbon-like fusion of the two layers of the cut foreskin, which is approximately one-thirty-second of an inch thick. Ideally, bleeding does not occur because the strong force applied adheres the two surfaces together, and blood clotting mechanisms hold them in place. Generally, the practitioner does not need to apply sutures, and the incision heals within a few days. The risk of infection is low because the two layers of the cut foreskin seal together.

From an engineering perspective, the Gomco clamp works as a force multiplier. It consists of two simple machines that work together, a lever and an inclined plane, to dramatically increase the force that human muscles can supply. A typical adult can produce about forty to 100 pounds of force when turning a screw with their dominant wrist. The Gomco clamp converts that muscle force into 8,000 to 20,000 pounds of crushing force on the foreskin. Wan notes that Goldstein may have been inspired by a lever tool used to change tires on the Ford Model T automobile.

The Gomco clamp combined aspects of earlier devices but improved upon them to make circumcision safer and faster. For instance, the Gomco clamp contains a cap that covers and protects the glans, as some other devices did. But it added an arm to separate the penis from the screwing action of the clamp to prevent torsion, which could twist the penis and result in an uneven cut. Additionally, the arm doubled the force available and, therefore, the pressure applied to the foreskin to stop blood loss. As Yellen stated in his 1935 article describing the device, it was also small, light, and easy to operate without an assistant. In that same paper, Yellen reported that he had performed 500 neonatal circumcisions without infection or hemorrhage using the clamp. In another paper, published in 1939, one doctor reported that he had used the Gomco clamp to safely perform 300 circumcisions without complications. Yellen claimed that a circumcision with the Gomco clamp requires less time than any other method.

In Yellen’s original description of the technique, he states that the procedure does not require anesthesia. That is because doctors at that time believed that newborns could not feel pain, so they did not believe circumcision warranted anesthesia. It was not until the 1980s when scientists learned that newborns could indeed feel pain that doctors began using Tylenol as anesthesia. In the 1990s, researchers showed that Tylenol did little to numb pain and therefore they recommended stronger pain medications, called analgesics. As of 2025, physicians typically use local topical anesthesia to numb the pain of circumcision.

The Gomco Clamp’s Impact

According to Wan, the Gomco clamp proved almost immediately successful and popular among physicians. An ad released at the 1935 annual meeting of the American Medical Association noted that the over 1,500 physicians and hospitals had adopted the device by that year. Wan, who wrote an article about the Gomco clamp in 2002, noted that tens of thousands of clamps soon sold annually. As of 2025, in the US, the Gomco clamp is one of several devices still in use that help doctors perform circumcision, but it remains the most popular among doctors and hospitals.

The introduction of the Gomco clamp shifted the responsibility of circumcision from surgeons to obstetrician-gynecologists, or the physicians who deliver babies. Since the nineteenth century, surgeons had been the ones to perform circumcision, and they usually performed the procedure on individuals later during childhood as a form of treatment rather than prevention. But by the early years of the twentieth century, some doctors were urging universal, infant circumcision. In 1914, for example, Abraham Wolbarst published an article in the Journal of the American Medical Association proposing that doctors should perform circumcision on all newborn males to improve hygiene, reduce the temptation of masturbation, and prevent sexually transmitted diseases. The lack of a standardized and safe method of performing circumcision on newborns hindered that push for universality. With the introduction of the Gomco clamp, obstetrician-gynecologists adopted the role of performing circumcisions shortly after birth.

According to Robert Darby, a medical historian who specializes in the history of circumcision, the Gomco clamp helped circumcision become a routine part of the childbirth process, overseen by ob-gyns. He cites as evidence an article coauthored by two ob-gyns and published in the American Journal of Obstetrics and Gynecology in 1953, which explicitly referenced the practical convenience, to ob-gyns, of immediate circumcision using the Gomco clamp as one of nine reasons to do it. Circumcision immediately after birth eliminated the need for a return visit to the hospital, prevented long lines of patients awaiting circumcision, eliminated foot traffic in maternity wards, and saved time for both ob-gyns and nurses, the authors state. They specify further that the mother signs the circumcision permit when she enters the labor room, and the ob-gyn performs the circumcision immediately after delivery. As a result, there is no conflict in scheduling of appointments and no male infants remain uncircumcised. The same authors report that, between 1939 and 1950, when doctors at their hospital in Ohio began practicing immediate circumcision using the Gomco clamp, 250 physicians performed 30,000 immediate circumcisions. The Gomco clamp also likely increased the profit margin of circumcision, since practitioners no longer required specialized surgical skills to perform it.

After seeing the Gomco clamp’s rise in popularity in the US, the Gomco clamp’s manufacturer attempted to expand its market into Europe, particularly Germany and Denmark, but they were largely unsuccessful. According to Frederic Hodges, another medical historian, Europeans resisted the idea of allowing doctors to surgically alter their children’s sexual organs for any reason, and neither the Gomco clamp nor the practice of neonatal circumcision caught on there.

Though advertised and promoted as a safe, bloodless, circumcision device, the Gomco clamp can still cause complications. In 2000, the U.S. Food and Drug Administration issued a warning about potential injury from the Gomco clamp and another device called the Mogen clamp, a tool similar to the Gomco clamp used to perform circumcision. During the period from July 1996 to January 2000, the FDA received 105 reports of injuries related to use of the clamps. One type of injury, called degloving, is when practitioners remove too much skin from the penis, exposing the underlying tissue.

Despite potential complications, as of 2025, circumcision remains one of the most commonly performed surgical procedures in the US, thanks in part to devices like the Gomco clamp. Circumcision rates reached a peak in the US of about 80 percent of newborns by the 1970s. Today, in 2025, the rate is about seventy percent, with a lot of variation between regions of the country and socioeconomic status. While routine neonatal circumcision remains common in the US, most other Western industrialized countries have abandoned the practice, on both medical and ethical grounds.

Gomco clamp inventors Yellen and Goldstein were responding to a perceived medical need in the 1930s when they created their device. At that time, doctors in the US increasingly performed circumcision as a hygienic measure to aid cleanliness, relieve or prevent a condition called phimosis, which is a condition where tight foreskin can't be pulled back over the head of the penis, lower the risk of getting a sexually transmitted disease, and prevent penile cancer, but there was no standard way of performing the procedure. Before the Gomco clamp, doctors relied primarily on simple surgical tools to perform circumcisions. The results varied according to the skill of the surgeon, and complications including bleeding and infections were not uncommon, especially since antibiotics were not yet available. By making the surgical procedure of circumcision safer, easier, and quicker to perform, the Gomco clamp helped to democratize who could perform the procedure, which in turn helped to institutionalize routine infant circumcision as part of the childbirth process in the US.

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