Introduction: Main limit of the Roux-en-Y gastric bypass (RYGB) is the preclusion of exploring the bypassed stomach with conventional endoscopy and radiological studies. For this reason, alternative procedures have been investigated for durable weight loss without any distal stomach left in situ. Laparoscopic sleeve gastrectomy (LSG), introduced as the first step of the biliopancreatic diversion with duodenal switch, has gained popularity as a single procedure for its effectiveness. Unfortunately, long-term weight loss results of LSG are still lacking. In an effort to join the advantages of RYGB and LSG while eliminating the disadvantages of both procedures some Authors have reported the feasibility of LSG with duodeno-jejunal bypass (DJBP) in the animal model. In this study we report the first world clinical experience with LSG and DJBP.Materials and Methods: 5 morbidly obese patients gave informed consent and were submitted to LSG and DJBP. Being a combination of previously standardized procedures we proposed the operation as a bariatric alternative in patients with morbid obesity. Routine pre-operative work-up included also a psychiatric visit. Laparoscopic standard sleeve gastrectomy was associated to a duodeno-jejunal bypass performed by transectng the duodenum and creating a gastro-jejunostomy. We evaluated operative time, complication rate and short-term weight loss.Results: Four female and 1 male patients entered the study. Mean age was 50.6 years (range, 46 to 53 years). Mean pre-operative BMI was 46.8 kg/m2 (range, 44 to 52 kg/m2). Mean operative time was 122 minutes (range, 85 to 142 minutes). Only one complication occurred with a patient who had a wound infection, successfully drained. Mean follow-up was 5.4 months (range, 3 to 8 months). Mean post-operative BMI was 39.8 kg/m2 (range, 37.6 to 41.0 kg/m2).Conclusion: LSG and DJBP has the potential to promote a similar weight loss of RYGB with no excluded gastric stump. LSG with DJBP has also the potential of enhancing the long-term weight loss associated with LSG. Our early experience seems encouraging. More patients and a longer follow-up are needed.