An instrument for fastening tissue within a body includes an elongated tube having a proximal end for extending outside of the body and a distal end for positioning proximate the tissue and a distal member configured to fold the tissue together. The distal member includes a first member having a proximal end coupled to the distal end of the tube and a second member pivotably coupled to the distal end of the first member. The first and second members are configured to install at least one fastener. A grasper is coupled to at least one of the first member and the second member. The second member is pivotable between an open position for receiving tissue and a closed position for folding tissue therebetween. The grasper is configured to project outward from at least one of the first member and the second member when in the open position.
