Ileostomy for diversion of the fecal stream in ulcerative colitis was advocated by Brown1 as early as 1911. During his surgical attacks upon diseases of the colon, Sir Arbuthnot Lane2 had completed 52 colectomies combined with ileosigmoidostomy by 1913, a number of which were for ulcerative colitis. By 1924, Strauss3 had established, in addition to ileostomy, onestage colectomy, primarily to remove the damaged bowel but also as a means to prevent debilitating relapses and complications. However, all ablative surgical approaches to the treatment of ulcerative colitis until recent years had been regarded as finalresort and crippling procedures to be employed when no further therapeutic measures were available.
Perhaps the most important contribution to the surgery of ulcerative colitis has been the introduction of the adherent ileostomy appliance, which was first described by Strauss,4 in 1944, and was known as the Koenig-Rutzen bag. Prior to this time