A surgical fastener apparatus includes a handle, a flexible elongate segment and an end effector having a fastener cartridge with a plurality of fasteners and an anvil, an approximator member movable relative to the longitudinal axis to cause relative movement of the fastener cartridge and the anvil between an open condition and an approximated condition, a fastener drive to deploy the fasteners from the fastener cartridge for crimping by the anvil, at least one tissue grasper at least partially extending along the end effector and movable to engage tissue and draw the tissue between the fastener cartridge and the anvil when in the open condition, and at least one manual actuator to actuate at least one of the approximator member, the fastener drive or the at least one tissue grasper.
