A 30 year old female patient, who was diagnosed as metabolic syndrome with BMI of 36.6, underwent laparoscopic sleeve gastrectomy. 30° reverse Trendelenburg position was employed. The operating surgeon stood on the patient’s right side. An 36-F orogastric tube was placed before the surgery. The entire greater curve of the stomach was dissected, to expose gastric fundus and the left crus of the diaphragm. The sleeve shaped stomach was dissected along the stomach tube 4cm away from the pylorus. According to the thickness of the stomach wall, different linear staplers were used. The cutting edge of the stomach was strengthened by continuous suture. The cutting edge of the stomach was reset and fixed on the greater omentum and the dorsal membrane of the pancreas. The excised gastric tissue was taken out through the main operation hole, the abdominal cavity was cleaned, the drainage tube was placed, finally the Trocar holes were closed.