The history of the location of the knot in intestinal surgery might be said to be the history of that branch of surgery itself, for, it would appear, that everything has hinged on the knot and its location. When this was outside of the abdominal wall intestinal surgery was in its infancy. The methods were crude, and the mortality high. As the knot began to make its way inward this branch of surgery advanced as a science. Crudity was replaced by a more perfect technic, and, as a result, the mortality rate was greatly reduced. Literally, the involution of the knot might be looked upon as the evolution of enterorrhaphy.
A brief glance at the various steps may not be out of order. It confirms the above and shows that the trend of surgical thought from the earliest times to the present has been a search for the best location
CONNELL FG. THE KNOT WITHIN THE LUMEN IN INTESTINAL SURGERY: WITH REPORT OF NINETEEN CASES. JAMA. 1901;XXXVII(15):952–965. doi:10.1001/jama.1901.62470410004001a
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