a medical device that includes a cannulated needle , a first knotting element portion releaseably engaged with the needle , a second knotting element portion also releaseably engaged with the needle , a knotting element deployment actuator that abuts the second knotting element portion , and an anchor deployment actuator in communication with the interior of the needle , wherein the knotting element deployment actuator and anchor actuator are slidably manipulable from a proximal handle of the device , and held in a coaxial relationship with each other . the first knotting element portion may be releaseably engaged by means including shearing posts and adhesives , and the second knotting element portion may be releaseably engaged by means including detents and adhesives .