Method and devices for securing bidirectional suture loops using coaxial mechanical fasteners

A surgical suturing instrument comprising:

• a handle;
• an actuator on the handle;
• an elongated shaft extending distally from the handle;
• a crimper disposed adjacent a distal end of the shaft and coupled to the actuator;
• an infusion port disposed adjacent the crimper for delivering an infusing fluid to a surgical site;
• and
• a fluid coupling disposed on the elongated shaft proximally from the port and fluidly connected thereto for receiving an infusing fluid at the coupling and delivering the fluid to a surgical site through the port.

A mechanical fastener for securing first and second loops of suture comprising:

• a crimpable cylindrical sleeve having first and second ends;
• a snare consisting of a single wire passing through the sleeve and forming a first loop extending from the first end of the sleeve, passing through the sleeve in the opposite direction looping around the sleeve and passing through the sleeve in the opposite direction a second time and forming a second loop, longer than the first loop and extending from the a second end of the sleeve, passing through the sleeve in the first direction and looping around the sleeve a second time;
• and
• a tall formed from first and second ends of the snare such that when the tail is pulled, the first loop and then the second loop are pulled sequentially through the sleeve in the opposite directions.