Remove stems from mushroom caps. With the 3/4 pound italian sausage, use a cookie scoop or spoon to scoop about a tablespoon and shape into meatballs. Place meatball into the mushroom caps. Using the tip of a knife, push the tip into the top of the meatball, swirl around to create a whole, then place a small goat cheese crumble into the top. Repeat with all mushrooms.
Place mushrooms on a baking sheet and into the oven for 15-20 minutes or until meat has cooked through.
For the skewers
On each skewer, place a piece of pineapple, then a sausage round, then a shrimp (I kept on the tail for looks, but remove it if you would like). Repeat with all skewers.
Place a large pan over medium heat and add 2 tablespoons of coconut oil. Once pan is hot, add as many skewers as possible to the pan without crowding it. Sprinkle skewers with a bit of salt before flipping them. They will need to cook for about 2-3 minutes per side. Repeat with all skewers.
Once all of the skewers are cooked, add a drop of pesto (or as much as you would like) on each sausage round.