IntroductionA colostomy is a surgical procedure that involves the creation of an artificial opening in the abdominal wall, known as a stoma, to selectively divert a portion of the colon to the outside of the body. This procedure is employed in a variety of clinical contexts, such as intestinal obstruction, colorectal cancer, inflammatory bowel disease, traumatic injuries or perforations of the colon, anal or rectal fistulas, and complicated diverticulitis. Its objective is to restore fecal evacuation in situations where normal colon function is compromised, with the aim of improving the patient’s quality of life and contributing to the treatment of the underlying pathology.¹The application of the extraperitoneal technique in the creation of a permanent colostomy represents an advanced surgical procedure that offers significant benefits by notably reducing complications such as parastomal hernias. Although it requires specific technical skills and careful consideration of each patient’s particularities, this methodology marks an important advancement in contemporary surgical practice.² Its implementation not only leads to a tangible improvement in postoperative outcomes but also contributes significantly to the quality of life of individuals undergoing ostomy procedures.³,⁴Parastomal hernias are a frequent complication that may arise following the creation of a colostomy or any type of ostomy. This type of hernia is characterized by the protrusion of intra-abdominal organs, such as the intestine, through a defect in the abdominal wall adjacent to the stoma. The clinical relevance of parastomal hernias lies in their considerable negative impact on the quality of life of affected patients. In addition to the discomfort and pain they may cause, these hernias have the potential to lead to serious complications such as intestinal obstruction, strangulation of the intestine, and problems with stoma function.⁵,⁶