Comment I just got back (Score 1) 24
I was there last week. It's very simply, you learn the name of the product you're buying (learning katakana can be helpful here but usually not necessary), Then you walk up to a counter or member of the sales staff and say (product name ) o kudasai. Then you flash your card and you're done. you don't have to figure out what they're saying unless they don't like your credit card. They already know you're a gaijin and couldn't care less.
The largest store is LLaox. your best chance for english speaking assistance is there. Look for a giant red sign saying The Computer (llaox has multiple stores in the area)
http://206.129.88.168/japan2/dump2/dcp_0088s.jpg for image of LLaox.
You may hear the area called by it's shortened nickname "Akiba".