Patent ID: 7678122

Claim:
A method of performing a treatment for gastroesophagheal reflux disease (GERD), comprising: providing a distal end of a shaft of a medical instrument with a proximally facing end effector, the shaft having a shaft axis, the end effector having a clevis with a jaw portion offset from the shaft axis in an offset direction wherein a shaft-effector plane is formed between the offset portion and the axis of the shaft, the jaw portion directing two opposing jaws separate from the shaft in a proximal direction, each of the jaws directly connected to one part of a two-part fastener, the jaws operable to actuate in an actuation plane at a non-zero angle to the shaft-effector plane; inserting the shaft with the proximally facing end effector and proximally facing jaws through the esophagus in a first direction; retracting the shaft of the instrument in a second direction substantially opposite the first direction; contacting the end effector against a stomach wall at a location substantially adjacent the esophagus; and manipulating the stomach wall with the end effector.