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A suturing device for use in endoscopic procedures includes a head configured to be removably coupled to an elongate medical device and an actuator coupled to the head via an elongate flexible sheath. The suturing device is configured to pass a needle and suture through a selected tissue site upon actuation of the actuator. In another embodiment, a suturing device includes a head and a retaining portion configured to receive a guide wire. The suturing device can be inserted into a patient's body using the guide wire to guide and help position the head of the suturing device. In such an embodiment, the suturing device can also include an expandable member coupled to the head and that is configured to be expanded within a body lumen of a patient to help maintain a position of the head within the body lumen.