A surgical instrument includes a body, at least one user input feature, an elongate shaft extending from the body along a longitudinal axis, and a needle applier coupled to the elongate shaft. The needle applier further includes a needle and a drive assembly coupled to the needle. The drive assembly is configured to rotate the needle along an orbital path about a rotation axis that is transverse to the longitudinal axis, in response to an actuation of the user input feature. The surgical instrument further includes a coupler operable to couple the surgical instrument to an endoscope for use in, among other surgical procedures, gastric reduction procedures.