Systems and methods for creating anastomoses

A system for forming an anastomosis between bodily lumens, the system comprising:

• an endoscope having first and second working channels through which elongate medical instruments may be employed;
• an elongated cutting device;
• an elongated grasping device;
• and
• an elongated needle having a needle lumen containing two tissue fixation devices for fixing two portions of a bodily lumen;
• wherein the cutting device and grasping device are structured for use with the first working channel and the elongated needle is structured for use with the second working channel, and wherein the grasping device is independently operable from the needle and tissue fixation devices such that the grasping device may be tensioned proximally while the needle is advanced distally, and such that the tissue fixation device may be tensioned proximally while the cutting device is advanced distally.