Suture clip deployment devices with suture tensioning systems

A device for deploying securement devices onto sutures, the apparatus comprising:

• a handle portion having a trigger and a suture tensioning mechanism
• a shaft portion extending distally from the handle portion;
• and
• at least one suture securement device positioned at a distal end portion of the shaft portion
• wherein the apparatus is configured to receive a suture extending through the suture securement device, across the trigger, and to the suture tensioning mechanism
• wherein actuation of the suture tensioning mechanism adjusts tension in the received suture
• wherein the trigger is actuated by the suture when a predetermined amount of tension is reached in the suture;
• and
• wherein actuation of the trigger causes the suture securement device to be deployed from the shaft portion onto the received suture;
• wherein the handle portion further comprises a peg positioned on a first side of the trigger, wherein the suture tensioning mechanism is positioned on a second side of the trigger opposite the peg, and wherein the suture extends from the suture securement device around the peg, and the suture extends from the peg across the trigger to the suture tensioning mechanism.