An apparatus and method for gastric reduction is provided comprising a tissue gathering assembly for applying a force to inner portions of a stomach to collapse the inner portions toward the tissue gathering assembly, and a suture assembly moveably mounted to the tissue gathering assembly for advancing a suture into the inner portions to form a gastric sleeve. The tissue gathering assembly may further comprise a vacuum shaft having sections of apertures, wherein each section transmits a vacuum force through the apertures to gather a part of the inner portions of the stomach to form a channel that connects an upper pouch to a lower pouch of the stomach. The suture assembly may further comprise a rotatable helical suture for fastening the gathered inner portions to secure the gastric sleeve.