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The ideal sleeve gastrectomy for a patient with a high risk of hypoglycemia. RYGBP is not suitable for all morbid obese patients. The sleeve gastrectomy is a valid option that should be performed properly to avoid complications and ensure the best long-term result for our patients. Antonio M. Lacy, Ricard Corcelles and Maria F Hevia used new tools to perform the ideal sleeve gastrectomy.