Hello,

You are saying that you do not have a "File>New>Sketch Project" menu item?

This is normally because when you started Visual Studio you selected web development or another layout. Some of the more advanced layout such as "General" have two menu items "File>New" other do not. Visual Micro does current add menu items to the "New" menu. 

1)
If you DO have a menu called "File" with a sub menu called "New" then click "tools>visual micro>reset user interface" this will put the option in to create a sketch



2)
If you do NOT have the two menu items File and New then you can switch to the "General" Visual Studio layout using tools>options and then follow the note in point 1) above. 

Or you can find the Visual Studio tool bar button/icon called "New Project" or "New Web Site". It is a menu button so also has a menu. Visual micro adds "Sketch Project" as a menu item..

Or you can add the menu items yourself via "Tools>Options>Customise>Commands". use the "Add Command" and select a Visual Micro command from the Addins section. All visual micro commands are available as commands/macros that can be placed on any toolbar or menu.

.........

Hope I was on the right track.