OBJECTIVE To evaluate the laparoscopic approach in the creation of loop ileostomies and sigmoid colostomies. DESIGN Prospective open study. SETTING University hospital, Sweden. SUBJECTS Eighteen consecutive patients who needed faecal diversion. INTERVENTIONS Laparoscopic loop ileostomy (n = 6) or sigmoid colostomy (n = 12). MAIN OUTCOME MEASURES Mortality, morbidity, and duration of operation. RESULTS There was no 30-day mortality, and no patients developed infections. The operating time (median 47 minutes, range 45-115 for ileostomies and 50, range 42-102 for colostomies) was comparable to open surgery. Two operations had to be converted to open procedures because of dense adhesions. Postoperative paralytic ileus was transient, and all patients started oral intake on the first postoperative day. CONCLUSIONS The laparoscopic technique is easy to do, it takes no longer than open surgery, and it causes minimal trauma, allowing the patients to recover faster.