The physician changes a gastrostomy tube via percutaneous approach. No imaging or endoscopic guidance is utilized. If the old gastrostomy tube has been placed endoscopically, the physician must remove it by snaring and pulling it out through the mouth. A new tube is placed percutaneously through the abdominal wall via the existing tract. A small incision is made through the skin and fascia. A large bore needle with suture attached is passed through the incision into the lumen of the stomach. The needle is snared and the needle and suture are removed via the mouth. The gastrostomy tube is connected to the suture and passed through the mouth into the stomach and out the abdominal wall. The gastrostomy tube is sutured to the skin.