A surgical procedure is disclosed for joining, e.g., by stapling or clipping, body tissue of a patient situated in an internal body cavity of the patient from within the body cavity through a small opening into the body cavity. For example, the surgical procedure may be employed to repair indirect inquinial or femoral hernias in a laparoscopic procedure. A small opening is made into the body cavity at a site on the patient's body remote from the body tissue to be joined in the internal body cavity. The body cavity is insufflated. An elongate tissue-joining instrument is inserted into the body cavity through the small opening. The instrument is moved through the insufflated internal body cavity to position a distal end of the instrument close to and on an internal side of the body tissue to be joined in the body cavity. The pieces of body tissue are then joined by the instrument by manipulation of the instrument at a proximal end thereof.