Medical devices, kits, and methods for utilizing an elongate surgical needle that may be used through an endoscope working channel or through an external accessory channel device used with an endoscope are provided. The needle has a proximal end and a flexible distal end, an opening at or near the proximal end and an opening at or near the distal end, the openings defining a channel. The surgical needle distal end comprises a tissue engaging section and an intermediate section being operatively coupled in an axial direction. The tissue engaging section and intermediate section have different flexibility such that the tissue engaging section has greater flexibility than the intermediate section. Optionally, the needle distal end has a preformed bend at or near the tissue engaging section, the preformed bend capable of being constrained to a substantially linear configuration and capable of returning to the preformed configuration when unconstrained.