A medical device configured to manipulate tissue within a body of a subject may include an elongate shaft having a proximal end and a distal end. The distal end of the shaft may be configured to be inserted into the body. The device may include end effectors coupled to the distal end of the elongate shaft. The end effectors may include a needle pivotably coupled to the shaft and configured to inject a fluid into the tissue. The end effectors may also include an articulating arm pivotably coupled to the shaft, and a cutting wire extending between the needle and the arm.