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THE ROSS CIRCUMCISION RING AND CIRCUMCISION BY LIGATION: A BRIEF
HISTORY OF THE RING AND ITS INVENTO
Richard S. HURWITZ
Kaiser Permanente Medical Group, Los Angeles, USA
ABSTRACT
The Ross circumcision ring is a forgotten device that was invented in 1939 by Dr. Cecil J. Ross who practiced urology in
Portland Oregon. It was the first of the tourniquet devices that dealt with foreskin removal by necrosis. It was sold as a
set of 6 reusable metal rings ranging from neonatal to adult sizes. The rings were supplied in an attractive walnut box
and included an initial ligature and articles by Dr. Ross that discussed technique and precautions.
The rings were constructed with a groove for the ligature, a lance guide and scissor guide, and a bale or handle which
could be held with forceps for adjusting the position of the ring. Ross stressed that the ligature must be tied as tightly as
possible and must have a tensile strength of at least 20 pounds. After ligation, the prepuce distal to the ligature was
excised “because its retention is unsightly”. The ring was left in place for 48-72 hours.
Ross believed that circumcision was “the most flagrant example of a common surgical procedure which has suffered
from indifference on the part of the surgeon”.
The main goals of the ring were to provide a bloodless and suture-less means of circumcision by ligation while
decreasing post operative discomfort and producing a better cosmetic result.
The Ross ring was the precursor of the Plastibell (1950) and other ring devices.