For patients with low rectal cancer who cannot undergo anal preservation surgery, a permanent sigmoid stoma is required. There are many stoma methods, mainly transperitoneal (fixed/unfixed sigmoid colon and lateral peritoneum) and extraperitoneal enterostomy. However, the specific operation varies from person to person, and the purpose of this article is to introduce the operation procedure and experience of individual extraperitoneal stoma. 1.Location selection: The stomatologist should pre-design several alternative positions according to the patient’s habit of tying the trouser belt before operation, and an auxiliary poke card can be played in this position during operation. 2, Adequate freeing of the lateral peritoneum with the aid of laparoscopy. 3, A circular skin of 2.0 cm in diameter is excised at the marked location. 4, The subcutaneous tissue is pulled away to reveal the anterior rectus abdominis sheath, and the anterior rectus abdominis sheath is incised longitudinally without the need for a cross cut. 5, Separate the rectus abdominis muscle to reveal the posterior rectus abdominis sheath. 6, Incision of the posterior rectus abdominis sheath without cutting through the peritoneum. 7, along the anterior peritoneal gap to the dorsolateral side of the free plane of the peritoneum, and the intra-abdominal peritoneal free plane will be met. The red dashed line is the free pathway. 8, put forward the fistula intestinal tube, establish pneumoperitoneum to check the intestinal tube direction and lateral peritoneal coverage. 9, The stoma intestinal tube plasma muscle layer and the anterior rectus abdominis sheath are fixed with 3 interrupted sutures, as long as the intestinal tube tension is not a problem, there is no need to fix too many sutures. 10, The stoma skin and colon were fixed with 4 stitches according to interrupted sutures of dermis, plasma membrane and whole layer, so that the intestinal canal was slightly turned out. 11.The skin dermis and intestinal canal are fixed with interrupted sutures in the whole layer, and the stoma is finished.