Sleeve gastrectomy, similar to other bariatric and metabolic surgical procedures, is generally contraindicated for patients with significant uncontrolled medical conditions such as active cardiac disease, advanced pulmonary insufficiency, or active malignancy. Furthermore, individuals lacking the cognitive capacity to fully understand the surgical process, its risks, and the imperative post-operative dietary and lifestyle modifications (whether due to congenital conditions or acquired impairment) are not considered suitable candidates. Additionally, for sleeve gastrectomy specifically, patients with severe pre-existing gastroesophageal reflux disease (GERD) are typically not recommended for this procedure.