A method for creating a plication within a hollow organ. The method uses an elongated member having an end effector at its distal end. The end effector has an outer cylinder having at least one opening in its cylindrical wall, and an inner cylinder having at least one opening in its cylindrical wall. The inner cylinder is at least partially disposed within the outer cylinder such that the apertures can at least partially overlap. The cylinders are rotatable with respect to each other. The method includes the step of inserting the end effector within an organ of a patient such that it is in contact with tissue. The method also involves applying vacuum through the elongated member so as to dispose tissue within the inner cylinder. The method also involves creating a plication by rotating the cylinders with respect to each other.