Mine was done laparoscopically with the main/largest incision through the naval, and 4 other tiny "nicks" around my abdomen for the other tools needed to perform the procedure. My surgeon explained to me he has performed a single incision lap procedure thru the naval, but wasn't as comfortable with that approach and a 2nd tiny incision was always needed anyway in order to manipulate the forceps and hold the liver out of the way. So he reverted to a more traditional lap approach with the 5 total incisions and finds that preferable.