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This is a laparoscopic pancreas sparing, segmental resection of the distal duodenum for a GIST. A 65 year old female presented with GI bleeding, the diagnosis and initial bleeding control were done endoscopically. Imaging confirmed location and vascular supply. We begin with an extended Kocher maneuver to the ligament of Treitz. The tumor is identified and the duodenum freed from the superior mesenteric vessels. An extraserosal dissecton off the pancreas is done using ultrasonic shears. The jejunum is divided at the ligament, the duodenum divided just distal to the ampulla. A two-layer handsewn anastomosis is created. Pathology demonstrated a 3.9cm low-grade GIST with negative margins.