A suture device is configured to form a purse string suture in procedures such as, e.g., transanal total mesorectal excision (TaTME), for removal of low rectal and ultra-low rectal tumors and preservation of anal sphincters to avoid permanent stomas. The suture device may provide uniform needle rotation, tissue penetration, and/or suture advancement independent of the skill of the clinician. The suture device includes a plurality of needles operatively associated with a needle driver such that rotation of the needle driver transitions the plurality of needles between a retracted position, in which, the plurality of needles extends radially inward, and an extended position, in which, the plurality of needles rotates to extend radially outward to engage and pierce through tissue to form a purse string suture.
