Enteral feeding is preferable in patients with failure to thrive and certain patients benefit more from post-pyloric enteral feeding. Laparoscopic feeding jejunostomy tube has become standard for the surgical approach to feeding j-tube placement. However several challenges remain including intracorporeal suturing, tube insertion and tube clogging and dislocation. A case presentation is described with an improved technique utilizing directional barbed suture and a modified t-tube for laparoscopic feeding jejunostomy tube placement.