This document discloses, among other things, a long reach, side ejecting fastener placement apparatus suitable for use in nasal septal surgery. A first linear member carries a fastener body and a second linear member delivers a fastener retainer or provides support for placement of the fastener body. In various examples, the fastener includes a single stud rivet or includes a two legged staple. A mechanical linkage coupled to the handle provides a linear force for placement and deployment of a fastener.