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 multiple 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 described that includes a staple applying assembly having first and second jaws, and a tissue acquisition member that extends substantially parallel to a plane running through the first and second jaws. The tissue acquisition member is effective to engage and position tissue between the first and second jaws, and the jaws are effective to apply at least one staple to the tissue engaged therebetween.