A surgical fastener apparatus includes a handle, a flexible elongate segmentand anend effector having a fastener cartridge with a plurality of fasteners and ananvil, anapproximator member movable relative to the longitudinal axis to causerelative movement ofthe fastener cartridge and the anvil between an open condition and anapproximatedcondition, a fastener drive to deploy the fasteners from the fastenercartridge for crimping bythe anvil, at least one tissue grasper at least partially extending along theend effector andmovable to engage tissue and draw the tissue between the fastener cartridgeand the anvilwhen in the open condition, and at least one manual actuator to actuate atleast one of theapproximator member, the fastener drive or the at least one tissue grasper.
