Thanks for writing,Your photo unfortunately does not help with an understanding of your belly wall. I always like to think in layers. What is the skin like? Strong or weak, tight or stretched. What is the fat under the skin like? Smooth and full, lumpy or irregular, in multiple isolated pockets. What are the rectus muscle like? Strong and aligned or separated and weak. What are the oblique muscle like? Strong and tight or stretched and weak. Based on all these answers and a good physical examination only then can one specifically answer the laparoscopic question you have asked. Good LuckStephen M. Davis, MD, FACS, Board Certified Plastic SurgeonMember: American Society for Aesthetic Plastic SurgeryMember: American Society of Plastic Surgeons