PEG placement is routine because endoscopic transillumination assisted direct percutaneous access (ETADPA) to the anatomically fixed stomach can be accomplished routinely. ETADPA to mobile lumina (e.g. jejunum) often fails because the endoscopic transillumination cannot be maintained. We describe a technique to facilitate ETADPA by magnetic-coupling to achieve transient luminal fixation to the anterior abdominal wall. Methods: In a swine model, NdFeBr internal disc magnets (IM) of three sizes and gauss were advanced, tethered to a wire extending through the endoscope accessory channel. Larger external magnets (EM) were applied to the abdominal wall at sites of transillumination. This was attempted at two locations of varying tissue thickness (measured at necropsy) in combination with each of the three IM and each of the two EM. Two investigators using visual analog scales assessed magnetic coupling forces. Results: The smallest IM (0.5” d, 5.5 lbs. lift) and medium IM (0.75”d, 11 lbs. lift) could be advanced through the UES, LES, and pylorus dragged along tethered to the side of the scope. The largest IntM (1.0” d, 15-lbs. lift) could not be passed. Upon transillumination the EM was applied and magnetic-coupling could be appreciated as a palpable click by the handler of the EM and witnessed endoscopically. On withdrawal of the EM, the IM behaved the laws of gravity. Following magnetic-coupling, trochar placement under endoscopic inspection was easily accomplished just proximal to the EM. At necrosection, abdominal wall thickness at the two locations measured 4 and 2.5 cm respectively. Discarding the largest IM, investigators assessments of magnetic-coupling confirmed strongest attraction between the block EM (2” × 1.5” × 0.5”, 12,200 gauss) and the medium IM. There were comparable levels of attraction between the block EM with the smaller IM and the disc EM (2” × 2.5”, 12,200 gauss) with the medium IM. Coupling between the disc EM and the smallest IM were weakest. There was no perceived difference in coupling forces at the two locations despite their varying depths of tissue thickness. Assessment of distinction between coupling forces reached statistical significance when the strongest was compared to the weakest attraction. Conclusions: Endoscopic magnetic-coupling can be used to transiently fix otherwise mobile segments of bowel to the anterior abdominal wall. This concept holds promise for minimally invasive therapies, in particular, direct endoscopic enteral feeding tube placement. Supported by an ASGE Research Grant