Total pancreatectomy is an uncommon procedure, even at most high volume pancreatectomy centers. Laparoscopic total pancreatectomy and splenectomy is a complex procedure requiring advanced laparoscopic skills. We present the case of a 68 year old male with significant comorbidities (including coronary artery disease, congestive heart failure, chronic kidney disease, diabetes, hypertension, and hyperlipidemia) with diffuse mixed type intraductal papillary mucinous neoplasm (IPMN) through out the pancreas. We performed a laparoscopic total pancreatectomy and splenectomy. Overall, the patient did well postoperatively, and was discharged home on postoperative day 8. Pathology revealed IPMN with focal high grade dysplasia diffusely involving the main pancreatic duct and multiple side branch ducts with no evidence of invasive cancer and 0 of 21 lymph nodes involved.