In a laparoscopic surgery, a camera is used to view the abdomen via the incisions. Small instruments are then used to perform the surgery through the multiple access points.
There are benefits to choosing laparoscopic surgery over an open procedure. Laparoscopic procedures lead to fewer wound complications such as risk of infection and patients usually experience less pain following surgery.
Laparoscopy patients are also able to leave the hospital sooner and get moving again more quickly than patients who've had an open procedure.
Not all patients are suitable for laparoscopy. Patients who are extremely obese, who have had previous abdominal surgery, or have complicating medical problems may require the open approach. Some surgeons still perform gastric bypass via open surgery based on preference and their experience level with the particular procedure.
You may wish to talk to multiple surgeons to discuss the pros and cons of each kind of procedure before making any final decisions about your surgery. While it is your personal option to choose between a surgeon who performs open or laparoscopic procedures, there are times when a laparoscopic procedure becomes an open procedure on the table due to complications or difficulties.
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Sources
Medline Plus Medical Encyclopedia: Weight-loss surgeries. Feb 2008. http://www.nlm.nih.gov/medlineplus/ency/article/007199.htm
Medline Plus Medical Encyclopedia: Laparoscopy. July 2007. http://www.nlm.nih.gov/medlineplus/ency/article/007016.htm
