Small bowel obstruction (SBO) is one of the most common complications associated with colorectalsurgery. The increased incidence of SBO when DI is created at the time of the initial surgery is ofparticular concern[4-8]. Since DI is brought up extracorporeally through the abdominal wall by splittingthe rectus abdominis muscle (RAM), scar formation or tissue inflammation at the anterior rectus sheath(where the incision is made) may lead to stenosis of the stoma opening (outlet). Furthermore, the stomaoutlet is physiologically vulnerable to the risk of obstruction, and its underlying mechanisms can beexplained by the following speculations. First, the stoma is edematous, and the bowel lumen tends to benarrower in the early postoperative period. Second, the intraluminal pressure of the small bowel islower than that of the colon, suggesting relative stenosis at the RAM level[9]. Third, if a high volume ofbowel content flows into the lumen, the stoma outlet may have a change in caliber, leading to relativenarrowing[10].