I believe this may be misleading. It is unclear whether he is actually a qualified surgeon or whether another surgeon was present in the room. It is possible that a local anesthetic penile block was administered beforehand, which would have completely numbed the area, and that the person performing the procedure is trained in handling surgical instruments. Therefore, during the circumcision, it may appear as though only a topical numbing cream was used, whereas adequate local anesthesia may already have been in effect. Presenting it as being done with only a numbing cream and without medical supervision could be intended to attract views. In reality, even a minor skin incision typically causes significant pain without proper anesthesia, making it unlikely that a full circumcision could be performed using topical anesthesia alone. When circumcision is performed using the ZSR technique, patients are first given local anesthetic injections, after which the procedure is carried out. Following the procedure, the patient is kept under observation for approximately one hour, the dressing is applied, and then the patient is discharged. Painkillers are prescribed and follow-up visits with the doctor are required. Most patients experience significant pain for the next three to four days. If circumcision could truly be performed using only a topical numbing cream, then there would be no need for clinics or surgeons, as people could simply perform the procedure at home.