Single-stage laparoscopic sleeve gastrectomy (LSG) may represent an additional surgical option in the treatment of morbid obesity. We performed a retrospective review of a prospectively maintained database of patients undergoing LSG from Nov 2004 to Oct 2006 as a one-stage restrictive procedure.119 LSGs were performed. 105 (88%) were primary procedures; M:F=1:3, mean age 42 yrs (range 13-79), mean BMI 43kg/m2 (range 35-66). All procedures were completed laparoscopically. The mean duration of surgery was 94 mins (range 60-180) with a mean blood loss of 65 mls (range 20-300). The mean length of hospital stay was 2 days. 1 patient underwent reintervention for abdominal pain on postoperative day (POD) 1 requiring laparoscopic primary closure of a staple line leak close to the gastrooesophageal junction. Short-term outcome data is available on 66 patients (71%) who have been followed for >3 mon; 52 patients (56%) have >6 mon follow-up with >1 yr follow up in 16 patients (17%). The mean weight loss is 24kg (range 19-30) at 6 mon and 51kg (range 24-44) at 1 yr. A further 14 patients (12%) had a LSG after failed laparoscopic adjustable gastric banding (n=11), failed attempt at laparoscopic Roux-en-Y gastric bypass due to adhesions (n=1), or previous jejunoileal bypass with weight regain (n=2); M:F=1:4, mean age 48 yrs (range 16-69), mean BMI 41kg/m2 (range 35-55). Only 1 procedure was not completed laparoscopically (7%). This patient had a jejunoileal bypass >30 yrs previously and had chronic renal and liver failure. All 11 laparoscopic adjustable bands were removed during the same procedure. Mean operative time was 122 mins (range 85-180), mean blood loss was 98 mls (range 40-200), and mean length of hospital stay was 2.9 days (range 2-4). 1 patient underwent reintervention for abdominal pain on POD 2 requiring primary closure and omental patchplasty of a presumed ischaemic perforation adjacent to the staple line secondary to a coagulation injury. In summary, 2 patients required reintervention in our series resulting in a major complication rate of 1.8%. All patients had a gastrograffin swallow on POD 1 allowing early leak detection. A further 3 patients required readmission for mild dehydration. In conclusion, LSG is an effective and safe primary restrictive procedure to achieve weight loss.