Multi-position tissue manipulation assemblies are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably disposed through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. One or all the articulation controls and functions can be integrated into a singular handle enclosure connectable to the tissue manipulation assembly via a rigid or flexible tubular body. A needle deployment mechanism may be positioned within the enclosure. Such a mechanism can have multiple positions adapted to lock and/or advance a needle assembly within the enclosure in a controlled manner as well as for deploying the anchor assembly.