A trephine stoma may be an attractive alternative for those patients who require a stoma but not a laparotomy. Twenty-seven consecutive patients were candidates for formation of a trephine stoma. A loop ileostomy was successfully constructed in seven patients and an end sigmoid colostomy in 15, while conversion to a formal laparotomy was necessary in five patients mainly because the sigmoid colon was immobile or there were extensive adhesions. The absence of a major abdominal wound made the postoperative course simple with little pain, a quick recovery, and early discharge from hospital.