I was able to fish through to get to mine from the underside. I was able to loosen a few bolts to "pull" the fender line back a little. It's a SUPER tight fit to get to it that way, but I was able to replace BOTH pumps, AND all the lines fishing some lines down through the top.
I've also removed the battery, and tray, and all that mess completely....TWICE....If you don't have small hands, or don't want to fight the tight space, thats the way to do it. It takes a little longer, and of course you can't test everything until you hook the battery back up, but it's still only an hour or so project.
Also, just an FYI, the local parts stores here (Napa, AutoZone, OReilly). ALL have the pumps reversed in thier system. If you ask for a "front" pump, then you get the one for the rear window. If you ask for a "rear" pump you get the one for the windshield. I just replaced BOTH, within a week of each other, as well as ran all new underhood lines. First time that feature has worked on the truck in over 100k miles!