Using an unsutured composite technique for loop ileostomy after laparoscopic low anterior resection significantly reduces parastomal hernia risk compared to a sutured technique.

• Parastomal hernia developed in 4.8% of the unsutured group versus 13.5% in the sutured group (risk ratio 0.35, p=0.047).
• Stoma formation time was shorter with the unsutured technique (median 24 min vs 31 min, p<0.001).

Surgeons may consider adopting the unsutured technique to minimize hernia risk and expedite stoma creation, although further evaluation of its individual components is warranted.