A quick Google leads me to believe a laparotomy procedure is essentially what most would call "open" as opposed to laparoscopic. This happens in WLS for lots of folks for various reasons, including liver too enlarged to navigate around laparoscopically, too much abdominal fat making the laparoscopic tools too short to reach everything as needed, too much scar tissue from prior operations in the way of navigating laparoscopically, etc. And some surgeons just plain prefer NOT to perform procedures laparoscopically because they feel they don't get to see or maneuver as well as with an open incision.
My surgery was performed laparoscopically, but I would have gone open if there was any reason to do so. The major difference will simply be additional time for the incision to heal after the surgery and a slight increased risk of incisional infection due to having a larger incision.
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*Jill* Highest known weight: 324 Weight on morning of DS surgery: 308.5 Got down to about 185 before pregnancy; Benjamin David born March 24, 2012, 7 pounds 11 ounces  Post-pregnancy: 206.5
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