Methods and devices for manipulating and fastening tissue

An assembly for forming a fold of stomach tissue, comprising:

• an elongate body having a distal end, a proximal end and an outer surface, the elongate body defining a longitudinal axis;
• a plurality of vacuum orifices positioned on the outer surface of the elongate body, the outer surface forming a sealing surface configured to adhere esophageal tissue to the outer surface of the elongate body using suction through the plurality of vacuum orifices, the plurality of vacuum orifices include a first section and a second section, the first and second sections both extending partially around the outer surface of the elongate body when viewed along the longitudinal axis, wherein the first section is rotatable about the longitudinal axis relative to the second section;
• a first stomach tissue shaper having a first shaft coupled to a distal end of the elongate body;
• a stomach tissue displacing element comprising an elongated wire having a distal end and a proximal end, the distal end having a helical coil for engaging stomach tissue;
• the first stomach tissue shaper having a lumen extending from a distal end of the stomach tissue shaper to a proximal end of the stomach tissue shaper, the lumen being configured for slidingly receiving the stomach tissue displacing element;
• the elongated wire of the stomach tissue displacing element extending through the elongate body and exiting the distal end of the elongate body, the elongated wire forming a curved portion between the distal end of the elongated body and the proximal end of the lumen in the stomach shaper;
• a fastener assembly configured for fastening a fold of stomach tissue;
• and
• wherein the first stomach tissue shaper is rotated relative to the elongate body and the stomach tissue displacing element is moved distally in the lumen so that the helical coil is configured to engage stomach tissue and is configured to pull the stomach tissue proximally into a mold formed by the first stomach tissue shaper being moved to a closed position relative to the elongate body, wherein a fastener is configured to be ejected out of the fastener assembly and into the fold of stomach tissue.