In this paper, we analyze and discuss the possibility of Laparoscopic sleeve gastrectomy being accepted as a primary and definitive procedure for obese patients with comorbidities. This is based on our postoperative and 5 years of follow-up result and comparing them with the data reported in the international literature. For comparison of the results, a narrative revision of the literature was performed, using the Medline, Pubmed, and data base publications (Medline, Lilacs, and Cochrane Library), looking for the term "Sleeve gastrectomy," "Obesity," "Bariatric surgery," "Laparoscopic surgery" including "Review" articles and also other 42 selected papers. The current results demonstrate very low morbidity (<10%), nil mortality (<1%), mean % weight loss after 5 years of follow-up of 57%, very satisfactory results regarding comorbidities or improvement. However, gastroesophageal reflux manifestation after the operation (20% to 31%) and the possibility of regaining weight after 5 years (15% to 75%) appear as points for analysis.