We developed a new and simple technique for a gastrostomy, which combines the benefits of the laparoscopic and open approach: under visual control, the correct site at the gastric wall is defined laparoscopically and, via a second trocar, the stomach is pulled out onto the abdominal wall to insert a Kasper catheter and place the sutures. Evaluated in a rat model, this procedure demonstrates safety and surgical feasibility on the grounds of a minimal invasive access. The case report of a 1-year-old boy may also prove the clinical benefit.