Provided herein are trans-abdominal gastric systems and related methods that are useful in a range of applications for accessing internal regions of a patient. A cannula has internal and external anchors to reliably secure the anchor to an abdominal wall of the patient. An introducer with a capture element facilitates system placement by retrograde introduction. Upon completion, the system is removed and the abdominal wall incision closed by sutures specially connected to the system that ensures reliably removal and suture closure in a configuration that is outside the abdominal wall. The systems and methods are particularly suited for use with conventional laparoscopic or endoscopic medical instruments.
