Abstract Obesity is considered to be the epidemic of the 21st century. Until now there are no known medical or phar-macological methods to manage obesity in ways that control it and signifi cantly reduce the comorbidities associated with it. Bariatric surgery has become the best alternative for management of obesity. Management of patients undergoing bariatric surgery requires referral centers with multidisciplinary medical groups com-mitted to choice and long term follow-up of these patients. Bariatric surgery continues to be the gold standard for surgical management of morbid obesity. Key words Morbid obesity, gastric bypass, laproscopic surgery, metabolic syndrome, diabetes type 2. In both developed and developing countries obesity has increased in an epidemic manner in the last 20 years: and the prognosis for the next 30 years is not optimistic (1). Th e poor results of medical management and the excellent results with low levels of complications of bariatric surgery have transformed this branch of surgery into the specialty which has developed most of all the surgical specialties in the last decade (2). Th is development is primarily due to the minimally invasive techniques which have been develo-ped since 1990 (3).Since 1977 gastric bypass procedures (GBP) have been the gold standard for surgical management of morbid obe-sity. Th is is mostly because of the good results obtained in terms of weight loss and correction of comorbidities proven over a period of more than 30 years (4). By 2002, sleeve gastrectomy had become the most frequently used of all bariatric techniques the world over, accounting for 75% of the procedures performed according to the American Society of Bariatric and Metabolic Surgery (ASMBS) (5).In simple terms sleeve gastrectomies mix restriction, with a gastric pouch of 30 cc, with reduced absorption through gastrojejunal derivation Roux-en-Y gastric bypass. Th is produces functional exclusion of the duodenum and the fi rst portions of the intestine, resulting in decreased food intake and causing varying degrees of malabsorption. Possible variations include diff erent sizes of reservoirs, the option of using restrictive rings along the length of the excluded intestinal loops and the choice of methods for performing the gastrojejunal anastomosis. In addition, the choice of whether to make the ascent in front of or behind the colon is diffi cult to standardize internationally which makes it diffi cult to compare results obtained in diff erent institutions.Sleeve gastrectomy is a complex technique which requi-res referral centers with well coordinated specialized surgi-cal teams, surgical inputs and operating rooms which are appropriate for obese patients in order to achieve rates of complications lower than 10% and perioperative mortality rates below 1% (6).Indications for performance of sleeve gastrectomy conti-nue to be those set out by the National Institutes of Health in the United States in 1991 (7).