Abstract: A method of ligating a vessel at multiple distant sites through a single surgical opening with a single length of suture filament is disclosed. The method in one embodiment represents an improved endoscopic vessel harvesting technique. An apparatus well suited for performing the method is also disclosed. The apparatus in one embodiment includes a hollow cannula for guiding and advancing loops through the body to the desired ligation sites. Ligation of an elongate tissue structure such as the greater saphenous vein at opposing proximal and distal ends is accomplished by this invention without clips, needles, internal stitches, multiple incisions, or the risks associated with these existing devices and methods.