Medical systems, devices and methods are provided for manipulating tissue, such as for closing a perforation in an internal bodily lumen. One embodiment of a medical system generally includes an endoscope, an endcap attached to the distal end of the endoscope, a plurality of needles attached to the endcap, a stylet cap slidably disposed of the endcap, a plurality of stylets attached to the stylet cap, and a plurality of tissue devices. The plurality of needles define a plurality of needle lumens and the plurality of stylets project distally into the needle lumens. The plurality of tissue devices are positioned within the needle lumens, whereby translation of the stylet cap relative to the endcap causes the plurality of stylets to engage the plurality to tissue devices and eject them from the plurality of needles. The medical system may further include a protective tip slidably attached to the plurality of needles.