Introduction: Laparoscopic Surgery has been associated with better post-operative short term outcomes, mainly because of the less associated surgical trauma, this benefits has been clearly documented in elderly patients. Over the last 2 decades there has been a significant increase in the utilization of laparoscopic surgery for management complex Gastrointestinal Malignancies.

Methods: In this video we report a case of combined laparoscopic Sleeve Gastrectomy for Gastric Gastrointestinal Stromal Tumor GIST and Spleen Preserving Distal Pancreatectomy for Mucinous Cystic Lesion in an elderly patient.

Results: 87 year-old male patient presented with anemia, found to have large submucosal mass at the gastric fundus, biopsy showed GIST, his CT scan also showed 2.5 complex cyst in the tails of the pancreas. Patient underwent successful laparocopic sleeve gastrecotmy for gastric GIST under endoscopic guidance to assure negative margin and spleen preserving distal pancreatecomy. He had the full benefits of laparocopic approach in terms of post-operative recovery and outcomes.

Conclusions: Combined laparoscopic resection of multiple pathologies is feasible even in elderly patient when surgical expertise is available to maintain the oncological principle and the full benefits of minimally invasive approach.