They're probably trying to strike a balance between enough length to not cause leaks and short enough to not cause problems with bulging out and to keep it discreet?  Not sure.  I'm lucky to have a pretty long stoma - a bit over an inch, and I never have leaks.  

Oh...I so agree...most I've read here, the trouble with leaks are very short stomas  or sunken in needed a concave shield for a wafer! I was sent a sample once by a new gal at Hollister and gave it a try...it lasted a day & gave me a bruise for about a week. My stoma is on average 1 1/2 " long and no one has ever asked about the little bump under my clothes. It's fairly easy to disguise anyways.

When I had my last scope, I did tell the Doctor who thought mine was prolapsed,  my theory on longer stomas verses short ones and how I thought it would improve the quality of life for Ostimates and save the already expensive  expense for those not covered,  if they were all made as long as mine on purpose. She said "really" that's very interesting...then the drugs hit & knocked me out cold!

I guess unless its talked about before hand & it really should be if you ask me, we may never know if changes are made. Maybe it's my age, but I do not fear direct conversation with my doctors abou these things like I did even ten years ago. Again...Knowlege is Power, have no fear.

Posted by: @rick

Why is it not standard practice to make the stoma at least a couple inch’s?

Not sure about a couple of inches, but I do believe that most surgeons are aiming for a slightly protruded stoma. Unfortunately, I think it's easier to say than done because each person's gut, belly, and muscles will be different. 

I do believe that stoma creation techniques have been refined over the last several decades, so patient outcomes are better, but nowhere near perfect.