Abstract: An endoscopic suture punch for use in endosurgical procedures, especially an anti-reflux procedure. This suture punch has an elongate frame and a handle mounted to one end of the frame. A pair of opposed jaws having tissue punches is mounted to the other end of the frame. One jaw is rigidly mounted to the frame while the other jaw is movably mounted to the frame, although both jaws can be movably mounted. An actuation handle is mounted to the frame for actuating the jaws. The suture punch has a suture pathway through the frame, the punches and the jaws for receiving the suture. There is a suture drive mechanism mounted to the frame for moving the suture through the suture pathway. The endoscopic suture punch is used with an invaginator for performing an anti-reflux procedure. The endoscopic suture punch may typically be used for suturing and other endoscopic procedures.