Methods and devices are provided for placing occlusion fasteners. In general, a surgical instrument is provided having a shaft configured to be introduced into a body through a scoping device and to deliver a ligating clip to occlude tissue in the body. The scoping device and the shaft can each be flexible, with the shaft configured to be advanced through a working channel of the scoping device. The shaft can have a size configured to allow a plurality of surgical instruments to be concurrently disposed in the scoping device's working channel and for one or more of the surgical instruments to extend beyond a distal end of the scoping device.