Construction of a Permanent End-Colostomy Using a 25 mm Circular Stapler to Prevent Parastomal Hernia Formation

The use of a 25 mm circular stapler for colostomy creation allows for standardization in the size of the abdominal wall opening. The aperture so created is large enough to accommodate the delivery of the colon, but avoids making a defect that is initially too large or becomes larger with time with the subsequent development of a parastomal hernia. The use of the stapler creates a reinforced circular defect rather than a linear one, which is a more durable fascial opening that better resists further enlargement from mechanical stress, thereby minimizing subsequent parastomal hernia formation.