The International Metzitztah Registry (which is presently being compiled) will consist of Mohalim from all over the world who are willing to, or exclusively use a pipette to fulfill the custom of Metzitzah. Using a sterile tube has a number of benefits. The lack of direct oral contact insures that both the Mohel and the baby are safe from transferring any infectious diseases. The tube is also Halachically equivalent to doing it with direct oral suction (Metzitzah B'peh), as was the custom. This is the best possible scenario because we can continue the tradition in a way that’s safe for all parties involved. If you're not sure of your Mohel's practice then ask. Many of those who's practice is direct oral contact will use a tube upon request. If you're looking for someone in your area, here's a list of Mohalim who do use a pipette: