Surgical instruments and methods for closing a gastrotomy. In various embodiments, the surgical instrument may comprise an overtube that supports a clip magazine therein that houses a plurality of tissue apposition clips in an orientation wherein the upper and lower clip arms thereof are releasably supported in an open orientation. Various embodiments are configured to operably accommodate one or more tissue grasping members for grasping the tissue. Other embodiments comprise clip dispensing adapters that may be affixed to the distal end of an endoscope. The various adapters are configured to support a tissue apposition clip such that the upper and lower clip arms thereof are initially supported in an open orientation relative to each other to enable grasped tissue to be drawn therein. Various tissue apposition clips are disclosed which may be used in connection with conventional tissue anchors and/or sutures.
