GIST are the most common mesenchymal tumors arising within the gastrointestinal tract and the treatment of choice of these tumor is surgical resection. Our aim was to describe a minimally invasive technique used for the wedge resection of duodenal GIST located near the pancreatic head, compressing the junction of D2 and D3.

A 27 year old female presented with nonspecific upper gastrointestinal system symptoms. The endoscopic ultrasound revealed a submucosal tumor arising from the muscolaris propria, located in the proximal part III of the duodenum, 2 cm distal of the papilla of Vater.A laparoscopic operation under general anaesthesia was undertaken with the patient in supine position with the legs abducted. Therefore, a laparoscopic Kocher maneuver was performed. The excision of the lesion was performed by use the harmonic scalpel. Then, the duodenal wall was sutured by use endoscopic stitches.

The resected lesion was then placed in a retrieval bag and extracted through the port incision. Operating time was 200 minutes and blood loss was 50 ml. The postoperative course was uneventful and she was discharged well on the 6th postoperative day. Histological findings showed a low grade of malignancy GIST and clear microscopic margins.

The minimally invasive technique may be a valid alternative to open surgery in the treatment of duodenal GIST. Laparoscopic wedge resection with primary closure can be performed if the resulting lumen is adequate and the ampulla of Vater can be preserved.