They do it laproscopically - 3-4 small incisions, one at the belly button, one mid stomach right above it, one just at the bottom of the sternum and maybe one more to the side. I only had 3 but I'm small. They pull it out at the belly button. The holes just take one stitch each to close. It only took 40 minutes from the time they started putting me under till I woke up in recovery. I jogged 2 miles a week late (at age 59). Eat no or low fat from now until 3 weeks after surgery. Then slowly start adding it back into your diet. You'll be fine.