A dynamic support system includes a control system for controlling inflation and deflation of at least one actuator having an inlet connectable to the a control unit of the dynamic support system. The system includes an elongate shaft having a proximal portion, a distal portion and a working channel extending at least partially through the shaft. The donor substrate has a cleave region underlying the gate layer. A pulling force is applied onto at least one of the loop ends, thereby drawing the perimeter of the opening onto itself to completely close the opening.