A surgical system for performing gastrointestinal procedures is disclosed. The system includes an elongated body defining an endoscope lumen. The body is adapted to be inserted into the esophagus with a proximal end extending from a body orifice. A working member includes at least one side disposed suction cavity and a cutting device configured to excise a surface layer from the tissue that is captured in the suction cavity. One or more needles are also provided in the working portion, which can be used to apply suture to the captured tissue and/or to inject fluid into the captured tissue prior to excision. Particular applications may be to treat Barrett's esophagus, to treat GERD, or for performing gastroplasty in the stomach.