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Although the procedure of laparoscopic sleeve gastrectomy (LSG) has been standardized either in conventional lateral to medial or medial to lateral approach, surgeons occasionally face the challenge of poor visualization of the His angle and difficulty in complete posterior mobilization in limited surgical field. This study aimed to introduce our novel details of modified approach to address these issues. One hundred patients with obesity underwent modified approach- three-port laparoscopic sleeve gastrectomy. Herein, we demonstrated our