The ancient physicians considered penetrating trauma with bowel perforation a fatal injury. Some would demarcate the wound and allow the formation of a natural fistula, but typically the patient did not survive. Direct suturing of intestinal defects was first reported by Brunschwygk and Paré during battlefield surgery in the 1500s. Around this time Paracelsus suggested the creation of an artificial anus for the treatment of penetrating abdominal wounds, however there is little evidence this was utilised. It was not until 1701 that Méry successfully treated an incarcerated hernia with a pelvic colostomy. By the 1750s, exteriorization of the bowel in the event of complete transection was recommended by Heister; while others chose to bring the lacerated bowel to the abdominal wall allowing peritoneal adhesions to close the defect. In 1793 Duret formed a colostomy in a neonate with proctatresia that functioned for 45 years. In the 1800s stoma nomenclature was developed, ileostomies were implicated in malnutrition and by 1840 techniques of stoma formation for bowel obstruction were being taught in medical schools. In 1921 Hartmann described his now ubiquitous technique of left inguinal colostomy. Throughout the 20th century stoma treatments, including reversal techniques, rapidly progressed, filling a vital role in cancer management and treatment of inflammatory bowel diseases. Over the last 50 years, stoma therapy and equipment have advanced considerably and stoma formation now improves quality of life for thousands of patients each year. 1] Garmanova et al (2019), History of surgery: the evolution of views on the formation of intestinal stoma. Hist. Med. 2] Hardy (1989), Evolution of the stoma. ANZ J. Surg