A medical device for ligation or approximating tissue is disclosed. The device has a cannula with proximal and distal ends. The distal end of the cannula has a beveled surface, and the cannula has first and second channels, the first channel extending axially through it, and the second channel extending from the beveled surface to the first channel. The device includes a suture with a slide end and a distal loop, as well as a slip knot securing the loop to the slide end. The slide end is threaded thorough the first and second channels of the cannula and it protrudes from the proximal end of the cannula. In addition, the device incorporates means for securing the positioning of the slide end of the suture in the first channel of the cannula. The device is particularly well adapted for use during endoscopic surgery when it is necessary to perform operative procedures through small openings in the body. The device is easy to maneuver and to position, and does not require the user to make the suture knot outside the body.