Laparoscopic Roux-en-Y gastric bypass is identical to the traditional gastric bypass except that instead of being performed through an incision extending from the lowest aspect of the breastbone (xiphoid process) to below the umbilicus (navel), it is performed through several smaller incisions each measuring about an inch or less in length. A laparoscope connected to a video camera is inserted into the abdominal cavity and the inside of the abdominal cavity is visualized on video monitors. Long thin surgical instruments and especially designed staplers are inserted through additional small incisions; the surgeon performs the surgery by watching the video monitor.

The advantages to performing the Gastric Bypass Laparoscopically are that it yields cosmetically superior results and the recovery is faster. Some long-term problems of open surgery, such as incisional hernias and wound infections, also occur less frequently. However, sometimes because of difficulty in visualization, the operation must be converted to an open procedure in order to complete the operation safely. This decision, of course, is made during the course of the operation while the patient is under anesthesia, so the patient must be aware of this possibility before the surgery starts. Another disadvantage is that the incidence of leakage from the surgical staple lines may be more common in the postoperative period. Leakage from the staple line is a serious complication and often necessitates additional surgery, usually using a traditional incision, and prolonged hospitalization, and sometimes even death.