Laparoscopic gastrostomy was performed successfully on six consecutive patients after the procedure was developed using a porcine model. These patients were unable to undergo percutaneous endoscopic gastrostomies because of obstruction from cancer or anatomical blockage. Operative time averaged less than 18 min. Three patients underwent the procedure under local anesthesia with intravenous sedation, and two patients were operated on in a strictly outpatient setting. No complications or deaths occurred. Laparoscopic gastrostomy appears to be a safe alternative to open gastrostomy in patients who cannot undergo percutaneous endoscopic gastrostomy.