Gastropexy was performed by the percutaneous introduction of two T-fasteners while the stomach was air insufflated. A third puncture of the air-insufflated stomach was performed between the T-fasteners with the 18G needle. Using this access, a 5 F angle catheter and guidewire combination were advanced across the pylorus, the duodenal sweep and into the proximal jejunum. The gastrocutaneous access was dilated by serial fascial dilated, followed by introduction of a 16F peel-away sheath. Through this a 14F MIC transgastric jejunal feeding tube was inserted, with its tip positioned in the proximal jejunum, just beyond the ligament of Treitz. The peel-away sheath was removed, and the gastric retention balloon was inflated with 15cc of sterile saline. The balloon and retention disc were fastened snugly.