This case describes a patient who suffered severe necrotizing pancreatitis, complicated by walled off pancreatic necrosis and an isolated pancreatic tail remnant, resulting in disconnected pancreatic duct syndrome and an enlarging pancreatic collection. We completed a laparoscopic transgastric cystogastrostomy, necrosectomy and in this case, the pancreatic tail remnant was resected transgastrically as well. This video aims to describe this complex technique. We first entered the abdomen with a hasson port and ensured the stomach was fully exposed to the anterior abdominal wall. With the abdomen partially desufflated, the stomach was insufflated with the endoscope, and Versa Step radially dilating trocars were placed across the antrum and body of the stomach under direct endoscopic guidance. One 12mm and two 5mm transgastric ports were placed, and insufflation was switched to a transgastric port. A laparoscopic ultrasound was used to image the area of the walled off necrosis, and the location was confirmed with needle aspiration. The collection was entered with cautery, and the cystogastrostomy was completed with vascular loads of the Endo-GIA stapler to ensure adequate hemostasis in the setting of gastric varices secondary to splenic vein thrombosis. The splenic artery was ligated transgastrically with Hem-o-lok clips, and smaller vessels were ligated with the ligasure. The pancreatic tail remnant was resected with a tan loaded Tri-Stapler Endo-GIA to ensure splenic artery hemostasis. The anterior gastrotomy port sites were closed with 2-0 silk suture. We hope this video clearly depicts our specific technique and demonstrates special considerations for patient specific anatomy.