History of Ostomy Surgery

His­tory of Ostomy Surgery ~ The Early Days: Poor Prog­no­sis for Blockages

Until the late 1700’s, a bowel block­age was almost always fatal. Since physi­cians had no knowl­edge of antibi­otics or ster­ile tech­niques, bowel surgery car­ried with it a high risk of infec­tion. Physi­cians avoided any surgery that entered the peri­toneum, the mem­brane that encloses the abdom­i­nal organs, where infec­tions were par­tic­u­larly dan­ger­ous. Instead, they pre­scribed treat­ments such as con­sump­tion of the heavy metal mer­cury, lax­a­tives, ene­mas, and horse­back rid­ing to help move stool through the diges­tive sys­tem. These did lit­tle to help the patient’s suffering!

The First Colostomy

In 1776, a French sur­geon named M. Pilore per­formed the first ostomy surgery after all other treat­ment attempts had failed to help his patient. With­out treat­ment, the patient’s bowel block­age was cer­tain to prove fatal. Pilore attempted surgery was a last resort attempt to treat the blockage.

To per­form the surgery, Pilore made an open­ing through the patient’s abdom­i­nal wall into the cae­cum, the first part of the large intes­tine. He pulled the free end of the bowel through the patient’s abdomen and stitched the bowel to the patient’s skin, cre­at­ing a stoma where par­tially digested food could leave the patient’s body. The first colostomy surgery was complete.

After surgery, the patient used what was prob­a­bly the first ostomy appli­ance: a sponge held to the open­ing with an elas­tic ban­dage to absorb any leak­age. With­out access to today’s appli­ances, the patient opted to keep his bowel clear by per­form­ing reg­u­lar enemas.

This first colostomy surgery suc­cess­fully bypassed the patient’s bowel block­age. Unfor­tu­nately, two weeks later, the patient died of an infec­tion in his small bowel, per­haps com­pli­cated by mer­cury poi­son­ing. An autopsy recov­ered two pounds of mer­cury in his bowel!

Colostomy: A Pro­ce­dure for Pioneers

Over the next cen­tury, the risk of infec­tion con­tin­ued to make any abdom­i­nal surgery extremely dangerous—but for some patients, surgery was the only option. A few brave physi­cians con­tin­ued to attempt surgery to treat bowel block­ages that would be fatal oth­er­wise. Between 1716 and 1839, twenty-seven colostomy surg­eries were recorded, but only six of the patients sur­vived. Ostomy surgery remained a pro­ce­dure of last resort until bet­ter med­ical tech­niques made such surg­eries safer.

Ostomy Today

Today, mod­ern sur­gi­cal tech­niques make ostomy an accepted—and much safer—procedure, a viable way to treat con­di­tions that inter­fere with the body’s abil­ity to elim­i­nate waste. Post-surgical care has also greatly improved. Today’s incon­spic­u­ous, odor-barrier pouches are a far cry from the first sponge and elas­tic “appli­ance!” Today’s ostomy surg­eries allow count­less peo­ple suf­fer­ing from bowel block­age, Crohn’s dis­ease, and other intesti­nal ail­ments to lead healthy, ful­fill­ing lives.