The Plastibell utilizes a concept used by some indigenous people where the young
                                                            boys to be circumcised wear their foreskins tightly tied around a reed in a manner
                                                            which strangles the foreskin until it begins to slough off. Then they sit in a stream
                                                            and allow their foreskins to be washed away by the water. Of course only the
                                                            concept of the Plastibell is the same, material and design show that we are dealing
                                                            with a modern medical device.

	STEP 1:  The preputial opening is stretched, if it proves to be too tight to allow the Plastibell to be inserted into the foreskin a dorsal slit has to be made.
	STEP 2:  After the foreskin has been cut open the bell can be inserted and placed on the glans
	STEP 3:  Now the Plastibell of appropriate size is slipped over the glans as far as the coronal sulcus (the rim).
	STEP 4:  The ligature is now tied as tightly as possible around the foreskin on the bell ridge, after one or two minutes allowed for crushing the skin the foreskin is trimmed off at the distal edge of the ligature.
	STEP 5:  The handle of the bell is snapped off leaving the bell and ligature in place. The urethral opening is unobstructed and allows the patient to urinate through the bell.            The rim of tissue under and distal to the ligature will die off and separate with the bell in 5 to 10 days.

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