There are various techniques for doing this procedure. An upper endoscope when you are under is a minor thing, and since it is inserted when you are under (so you don't gag on it all) would not be noticed by many. A bright light transilluminates right through all the tissues and allows the GI doc to position it in exactly the right insertion spot in the stomach (He can see where he is on a video), and then from the outside the incision is dead on. No peg too low or high in the stomach which causes problems. I suspect that some doctors have done so many of these they could do it in the dark with a blindfold on, hence the various different experiences.