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Ampullary tumors display a favorable prognosis compared with other periampullary tumors. This prognostic difference can be attributed to the early presentation and easy diagnosis by upper gastrointestinal endoscopy and simultaneous histological verification and to biological differences that may determine the prognostic superiority of these tumors. The therapy of choice is complete resection. In benign cases this can be achieved either by endoscopic resection or surgical transduodenal resection, whereas malignant tumors should be treated with a pancreatic head resection and lymphadenectomy. Here we describe the technique of transduodenal resection of a adenoma of the papilla of Vater.