Brief presentation of history of pediatric enterostomy

1. Seok Joo, Han
Department of Surgery, Yonsei University College of Medicine
Department of Pediatric Surgery, Severance Children’s Hospital
Seoul, Korea

6. The use of the jaws of ants
to suture wounds has been
sporadically reported from
several countries, as early
as the 10th century BC
and as late as 1984, a
range of nearly 3000 years.
The earliest mention of
ants used in surgery
occurs in the Samhita

7. From 1st millennium
BC to 450 BC (1000
BC?), the ancient
Indian surgeon
Sushruta(?) wrote
the Sushruta Samhita

8. “Black ants should be applied to the
perforated intestines … and their bodies
should be separated from their heads
after they had firmly bitten the
perforated parts with their jaws.
After that the intestines with the heads
of the ants attached to them should be
gently pushed back into the cavity”

9. In 1602, Fabricius Hildanus
(1560-1634), a German
surgeon, described an
adolescent whose intestines
protruded from the inguinal
area and whose stools were
discharged through an
intestinal opening. Years
before, this boy had fallen
onto a pile of wood, cutting
open his belly and
intestines.

10. Laurentius Heister
advocated that patients
with intestinal
wounds not be left
untreated, recommending
that the perforated bowel
instead be
stitched and closed or fixed
to the abdominal wall

11. In 1710, while present at the autopsy of a
child with imperforate anus, he explained to
the bystanders: "It would be necessary to
make an incision in the abdomen and place
the two parts of bowel together after
reopening them, or at least to bring the
superior part of the bowel to the abdominal
wound, which should never be closed and
which would perform the function of the
anus."

12.  In the year 1776, a certain Mr Morel, wine merchant
from Vert-Gallant, turned to Pillore because of
difficulty in moving bowels due to advanced rectal
carcinoma.
 Purgatives and 2 pounds of mercury had not
succeeded in improving Morel's condition.
 Pillore at last performed a colostomy which was
functioning well until the patient died 28 days later of
severe gangrene of the ileum, caused by the
enormous weight of the mercury that lay in this loop.
Pillore H (1797) Operation d'anus artificiel par la methode de Littre.
Actes de la Societe de Lyon 189

13.  The first surgeon who decided to
perform a colostomy on a child with
imperforate anus was Antoine
Dubois in the year 1783.
 Following Littre's idea, he
constructed an inguinal colostomy in
the child, who was 3 days old.
 Unfortunately, the child died on the
10th day. The colostomy was
described as functioning and the
edges of the wound as healed.

14.  Pierre Joseph Desault, one of the most
famous surgeons of his time, was
unsuccessful with Littre's procedure, but
modified the operation later.
 A similar, unsuccessful attempt was made
by Desault 1 year later on a 2-day-old
child with imperforate anus.
 The child died 4 days later, and the
specimen was modelled in wax.

16. 185 page

17. 544 page

18.  In the hands of Duret , however, this procedure was successfully used for the time
on a newborn child 10 years later: On October 18, 1793
 The wife of Michel Sedreves in Brales bore a son with imperforate anus.
 Duret, a ship's surgeon in Brest, decided on a perineal operation, at which the
rectum could not be found.
 Duret then attempted to establish a lumbar colostomy of a cadaver from the
poorhouse of Brest. The attempt failed.
 The next day Duret called all available physicians in Brest together in consultation
and ventured an inguinal sigmoidostomy which was declared a complete success.
 Amussat was able to report that this patient was still living 45 years later.

21. Jean Zulema Amussat
modified lumbar colostomy
and was successful in treating
several patients.
After witnessing his operation,
surgeons from England and
Germany propagated his
method in countries other
than France

24. Marriage with Emperor
1866, Groom: 15 yrs old
Bride: 16 yrs old,
Empress, Myeongseong
明成皇后
Father of Emperor,
Heungson Daiwongun
興宣大院君
Emperor, Gojong
光武 太皇帝, 高宗

25. The Joseon Wangjo Sillok (朝鮮王朝實錄
Veritable Records of the Joseon Dynasty)
includes 28 different sets of chronological
records, and each set covers one ruler's
reign.
It was compiled immediately after the death
of the ruler in question.
As such, the Veritable Records are not the
typical history planned and written by a
specific individual or team of individuals

26. 친히 활과 화살을 가지고 말을
달려 노루를 쏘다가 말이 거꾸
러짐으로 인하여 말에서 떨어
졌으나 상하지는 않았다.
좌우를 돌아보며 말하기를,"사
관(史官)이 알게 하지 말라."하
였다.
○親御弓矢, 馳馬射獐, 因馬仆
而墜, 不傷。 顧左右曰: "勿令史
官知之。"

27.  소쌍이 말하기를, ‘지난해 동짓날에 빈께서 저를
불러 내전으로 들어오게 하셨는데, 다른 여종들은
모두 지게문 밖에 있었습니다. 저에게 같이 자기
를 요구하므로 저는 이를 사양했으나, 빈께서 윽
박지르므로 마지못하여 옷을 한 반쯤 벗고 병풍
속에 들어갔더니, 빈께서 저의 나머지 옷을 다 빼
앗고 강제로 들어와 눕게 하여, 남자의 교합하는
형상과 같이 서로 희롱하였습니다.’ 하였다.
 이에 빈을 불러서 이 사실을 물으니, 대답하기를,
‘소쌍이 단지와 더불어 항상 사랑하고 좋아하여,
밤에만 같이 잘 뿐 아니라 낮에도 목을 맞대고 혓
바닥을 빨았습니다. 이것은 곧 저희들의 하는 짓
이오며 저는 처음부터 동숙한 일이 없었습니다.’
하지마는, 여러 가지 증거가 매우 명백하니 어찌
끝까지 숨길 수 있겠는가. 또 저들의 목을 맞대고
혓바닥을 빨았던 일을 또한 어찌 빈이 알 수 있었
겠는가.
 봉씨가 궁궐의 여종과 동숙한 일은 매우 추잡하므
로 교지에 기재할 수는 없으니, 우선 성질이 질투
하며 아들이 없고, 또 노래를 부른 네댓 가지 일
을 범죄 행위로 헤아려서, 세 대신과 더불어 함께
의논하여 속히 교지를 지어 바치게 하라."

28. " 初四日。 敎曰:
“中宮殿, 今日卯時,
誕生元子。 諸般擧
行, 令該曹依例爲
之。”
전교하기를,“중궁
전이 오늘 묘시(卯
時)에 원자(元子)
를 탄생하였으니,
여러 가지 거행은
해당 조로 하여금
규례대로 하게 하
라”하였다.
1871 신미

29. 初八日。 敎曰: “今日
亥時, 元子, 以大便不
通之證, 不幸産室廳撤
罷。” 又敎曰: “日前祗
告廟社與閟宮矣。 元
子今旣不幸, 則事當只
行告由。 而此無已例,
禮判就議廟堂, 卽爲擧
行
전교하기를,“오늘 해
시에 원자가 대변이
통하지 않는 증상으로
불행을 당하고 말았다.
산실청을 철수시키도
록 하라.”하였다.
1871 신미

30.  In the early morning of October 8, 1895, one of the "worst atrocities ever
in history" was committed in Korea as the Japanese troops stationed in
Seoul and a gang of thugs broke into the Gyeongbok Palace and
assassinated Empress Myeongseong.
 Name of operation to kill Empress Myeongseong was “Fox Hunting”.
 Miura Goro(三浦梧樓), the Japanese Minister to Joseon(Korea) was
the directors of the operation to kill the Empress, “Fox Hunting”

33. Therefore, many surgeons took to
perform the procedure and do all they
could to improve survival rates.
Especially in the 19th century various
ways to approach the colon have been
practiced with frequently disappointing
results
Inguinal colostomy
Lumbar colostomy
Laparocolostomy

34. Molecular asymmetry
Fermentation and
germ theory of
diseases
Spontaneous
generation
Immunology and
vaccination

36. • Pioneer of antiseptic surgery (Father of
modern surgery)
• By applying Louis Pasteur's advances
in microbiology, he promoted the idea
of sterile portable ports while working
at the Glasgow Royal Infirmary
• Lister successfully introduced carbolic
acid (now known as phenol) to sterilise
surgical instruments and to clean
wounds

37. • Lysozyme in 1923
• Benzylpenicillin in
1928
• Nobel Prize in 1945

38. On the behalf of a lot of effort in
human ancestor, the colostomy
becomes a safe procedure and has a
more defined place in handling
children with imperforate anus,
Hirschsprung's disease and other
surgical disease.