Spare tire access

Unless you have a very light camper, you will have to undo tiedowns and raise camper 6” or so on jacks to take weight off truck to jack it up. This should give you enough clearance to access and operate spare tire crank down. It does on my GMC.

Frankly with good quality truck tires it takes extreme bad luck to get flat.
When I was getting my set ready for cross-continent vacations, original plan was to have rear build-in Generator for emergencies, what with TC zooming on 6000lb was bringing concerns of COG.
At the time I was considering leaving spare at home as it adds several hundreds lb to rear axle.
But then Generac turned piece of ****, so I pulled it out and front hitch-mounted Honda solved all COG concerns.

Here is a recent thread on this topic.

We have never had a flat with camper on thankfully but I am going to think about how and what it would take to get the tire down now. I sort of like the idea of just adding an extension or possible a swivel to allow the winch to move. Maybe even a fitting that will let the cordless drill do the bulk of the work.

I did not find those.

You will find long topic about it in forum archives.
Some members rotated the winch drive into wheel well.
Others simply plan on removing the camper for wheel change.
I am with the 2nd.