Brunner's gland hyperplasia is a submucosal tumor-like lesion of the duodenum that is often diagnosed by upper gastrointestinal endoscopy. In general, benign tumors are followed up, but tumors that occupy the lumen, tend to grow, and/or bleed are candidates for resection. Endoscopic resection is performed, because the tumor is mainly localized in the deep mucosa to the submucosal layer; however, complications are more frequent in cases with a tumor diameter of more than 30 mm, and duodenal

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... tion by open surgery or laparoscopic surgery is needed. Endoscopic operation for a pedunculated Brunner's gland hyperplasia measuring 40 mm in diameter and occupying the bulb of the duodenum was expected to be difficult to perform. Therefore, we excluded the duodenal wall using laparoscopic assistance, and moved the tumor to the stomach through the pylorus and performed EMR. We report a case of Brunner's gland hyperplasia that was successfully operated by the described procedure.