This invention provides the instrumentation and method to perform a percutaneous restrictive bariatric procedure with very low associated risks as compared to other types of bariatric surgery because the procedure is truly minimally invasive. The procedures of the present invention are performed percutaneously and do not rely on laproscopic or endoscopic guidance. The procedures of the present invention percutaneously restrict the stomach by decreasing the size of the pouch and delay emptying of the pouch by reducing the size of the outlet.