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→Complex clamps: Wikify balanopreputial membrane.
The Smartclamp and a couple of similar designs are one way clamps, representing a mixture of the Gomco and Plastibell methods. The [[Glans penis|glans]] is inserted into the plastic tube, the [[foreskin]] pulled over it. The base plate of the outer clamping mechanism is pushed over the [[foreskin]] and cocked shut, jamming the [[foreskin]] between the bulging lower rim of the tube and the lower base plate. The [[foreskin]] is now cut off along the upper side of the base plate. The entire clamping mechanism remains on the [[penis]], until it - like the plastibell - falls off by itself after the clamped skin dies off in the following days.
All of these methods have in common that the [[foreskin]] has to be separated from the [[Glans penis|glans]] first. In case of the circumcision of a child, it is in most cases (see chart above) necessary to forcibly tear apart the [[synechia| balanopreputial membrane]], which fuses the [[foreskin]] to the [[Glans penis|glans]], either by violently retracting the [[foreskin]] or separating it by pushing a blunt instrument underneath the [[foreskin]], both of which can result in injuries and inflammations of the [[Glans penis|glans]].
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