The redundant sigmoid, which has been retracted upward over the abdominal wall, is inspected to determine the best site (Figure 11, A–A′) for dividing the bowel to serve as a permanent colostomy. The sigmoid is divided where it appears to be viable and will extend beyond the surface of the skin for 5 to 8 cm without being under undue tension. It is better to err in having extra colon beyond the skin margin rather than too little. Consideration must be given to the thickness of the subcutaneous tissues as well as postoperative distention in testing the length of colon mobilized for the permanent colostomy. The proximal end of the specimen is then divided at this point with a cutting linear stapler (GIA). Excessive fat tabs and thick fatty mesentery, if present, should be excised about the terminal end of the colon in anticipation of inversion of the mucosa with immediate fixation to the adjacent skin.