A device for creating a plication within a hollow organ. The device has an elongated member with distal and proximal ends. The distal end is for insertion into a body cavity. The elongated member has an end effector at its distal end. The end effector includes an outer cylinder having at least one opening in its cylindrical wall. The end effector also has an inner cylinder having at least one opening in its cylindrical. The inner cylinder is at least partially disposed within the outer cylinder such that the apertures can at least partially overlap. In addition, the cylinders are rotatable with respect to each other. In addition, the device includes a tubular channel running through the elongated member which is in fluid communication with the end effector. The channel has a vacuum source attached at its proximal end.