A surgical suturing device has a guide tip defining cuff receiving and tissue bite areas. The guide tip has at least one needle guide configured to guide at least one needle through the cuff receiving area and the tissue bite area. Another surgical suturing device has a guide tip defining cuff receiving and tissue bite areas. The guide tip has at least one pair of needle guides configured to guide both the needles of at least one pair of needles through the cuff receiving area and the tissue bite area. The guide tip also has at least one pair of ferrule receiving apertures. The cuff receiving area and the tissue bite area are oriented to avoid cross-over of a suture passed by the at least one pair of needles through tissue in the tissue bite area and a replacement anatomical device sewing cuff in the cuff receiving area.