Inclusion Criteria:  Aged 18 years and over Able and willing to give informed consent to participate Elective patient for colorectal surgery requiring formation of permanent end colostomy (This may include patients undergoing surgery for rectal or anal cancer, inflammatory bowel disease, diverticular disease and functional bowel disorders) Suitable to receive both trans-peritoneal and extra-peritoneal techniques  Exclusion Criteria:  Lacking the capacity to consent Having emergency surgery Previous or current abdominal wall stoma Intention to form loop colostomy, ileostomy or double-barrelled stoma Previous incisional hernia repair with disruption of abdominal wall layers Pregnant or breastfeeding (as determined by standard NHS procedures)