Abstract: A tool for use in placing sutures and tying knots is disclosed. The tool has a handle for grasping by a user of the tool, an elongate neck extending from the handle, and a moveable head attached to the neck. A needle is operatively connected to the head. The needle is moveable between a retracted position and an extended position. A needle drive mechanism is provided for moving the needle relative to the head, while a head positioning mechanism is provided for moving the head relative to the handle.