**1. Introduction**

Gastrectomy for weight loss was first described by Marceau et al. in 1993 as a restrictive component of biliopancreatic diversion [1]. Then they described the vertical sleeve gastrectomy as the first step of the biliopancreatic diversion-duodenal switch procedure in 1998 [2].

Unfortunately, the laparoscopic duodenal switch was associated with significant complications, especially in patients with high body mass index [3]. Thus, Gagner et al. performed laparoscopic sleeve gastrectomy (LSG) as the initial stage of a twostaged approach before BPD/DS and Roux-en-Y gastric bypass to optimize the performance status of patients at high surgical risk or extremely obese [4, 5]. Many of these patients achieved adequate weight loss and improvement in medical comorbidities

after the first sleeve gastrectomy, and the second stage was rarely required. Therefore, LSG has evolved into a stand-alone weight loss procedure over time.

Long-term data show that LSG is as similar in weight loss and comorbidity resolution as the Roux-en-Y gastric bypass and has similar mortality and morbidity rates [6]. It is now the most commonly performed bariatric procedure worldwide, owing to its technical simplicity, short learning curve, and effectiveness [7].

The procedure has not been standardized yet. Different technical nuances can be seen at various points throughout the process. In this section, we focus on our method in detail, including all operative steps, which we believe is the simplest and most effective technique after performing over 5000 surgeries at our institution.
