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Loop colostomy is traditionally prevented from retracting into the peritoneal cavity by a rod or other supporting device. The rod can be safely replaced by a single suture. The technique facilitates fitting of the ostomy bag and eliminates the need to remove the supporting element later on.
LOOP COLOSTOMY IS SECURED at skin level by some type of supporting device, ever since Maydl proposed a wooden rod or a goose-feather stem for this purpose in 1888.1 The following year, Kelsey suggested a harelip pin anchored to the skin edges around the stoma and passed under the bowel loop,2 although Turner, in his textbook of surgery, recommended an "old artery forceps" instead of a rod.3 The classic glass rod was reportedly Horsley's idea2 and was used with both its ends attached to a rubber tube. Although it became widely accepted, the glass rod was too bulky to permit a safe application of the ostomy bag, and this led Gabriel to introduce a rubber tube in lieu of a rod two weeks after surgery.4 Gabriel's tube was later shortened and used immediately rather than two weeks later,5, 6 sutured now to the skin edges above and below the stoma. A short piece of Penrose drain served the same purpose,6 although ready-made plastic devices in a variety of shapes made their appearance in the 1970s.
Attempts to improve fitting of the ostomy bag led to the development of another group of techniques...