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Laparoscopic transgastric resection of a large pedunculated gastric lipoma. Large gastric lipomas are a rare condition. They are often asymptomatic but may present with upper gastrointestinal bleeding or gastric outlet obstruction. We describe the case of a 52-year-old woman with a large gastric lipoma presenting with pain due to intermittent prolapse through the pylorus. The patient was treated using a novel approach of laparoscopic transgastric resection and was discharged on postoperative day 3. She suffered no complication and her histology confirmed a gastric lipoma with clear surgical margins.