Sleeve gastrectomy has now become one of the most popular operations in the treatment of morbid obesity. We present a clinical case of minimally invasive treatment of early suture failure after sleeve gastrectomy, from the archive of the authors’ clinical observations. Suture failure occurred on the day 4 after surgery. Endogastroscopy revealed a defect of 12 mm in diameter with infiltration at the edges. The technique of endoscopic sanitation of the abscess cavity and transcutaneous drainage of the abdominal cavity was used. After 14 days, the drainage in the abdominal cavity stopped functioning. Fistulography showed that it was not in the abscess cavity; according to endoscopic fistulography, hermetic sealing was achieved. After 2 months the fistula was completely closed. The patient was discharged with complete recovery. After 6 months, EGD revealed cicatrical changes; body weight loss: 55 kg. This clinical case demonstrated the possibility of combined minimally invasive treatment of a postoperative complication – gastric suture failure after sleeve gastrectomy.