A suture insertion device (120) includes a shaft (124), which is adapted to be inserted into a body cavity (154). First and second needles (160) hold respective first and second ends of a suture thread (122). First and second needle guides (130) are attached to the shaft and respectively hold the first and second needles. The needle guides have a first operative configuration in which the needle guides are held parallel to the axis of the shaft for insertion of the shaft into the body cavity and a second operative configuration in which the needle guides are deployed outward from the shaft within the body cavity so as to point the needles in a proximal direction. An ejector (164) is operative to eject the needles from the needle guides in the second operative configuration so as to cause the needles to penetrate tissue (156) adjoining the body cavity.