Devices and methods are provided for forming and securing a tissue plication. More particularly, the devices and methods of the present invention can be used to create tissue folds on an anterior and posterior wall of a stomach cavity to reduce the volume thereof. In one aspect, a tissue acquisition and fixation system is disclosed that includes an elongate shaft, an end effector coupled to the elongate shaft and having first and second jaws, and a tissue acquisition member coupled to the end effector by a linkage assembly. At least a portion of the linkage assembly and tissue acquisition member are slidably movable in a direction parallel to a longitudinal axis of the jaws. Further, the tissue acquisition member is vertically movable relative to the end effector such that a distance between a longitudinal axis of the tissue acquisition member and the jaws can be adjusted.