Abstract:
A system for incisionless transvaginal sacrospinous ligament fixation, the system including an anchoring unit configured to affix a vaginal wall to a sacrospinous ligament; and a piercing tip configured to: pierce said vaginal wall, pierce said sacrospinous ligament, and deploy a first portion of said anchoring unit though said pierced vaginal wall and said pierced sacrospinous ligament, thereby disposing said first portion at said sacrospinous ligament.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims the benefit of U.S. Provisional Patent Application No. 61/861,920, filed Aug. 2, 2013 and entitled “Anchor Delivery System and Method”, which is incorporated herein by reference in its entirety. 
     
    
     FIELD OF THE INVENTION 
       [0002]    The invention relates to the field of organ prolapse repair. 
       BACKGROUND 
       [0003]    There are a variety of medical devices and procedures used for supporting portions of a patient&#39;s body such as for treating pelvic organ prolapse. The pelvic floor of a patient includes muscles and ligaments that support organs, such as the bladder, colon, urethra, uterus, cervix, small intestine, or rectum within a pelvic cavity. Pelvic organ prolapse occurs when this normal structural support stretches or weakens, causing the descent or droop of the organs. There are four main forms of pelvic organ prolapse. Cystocele is a weakening of the vaginal wall causing the bladder to protrude into the vagina. Rectocele is a weakening of the back wall of the vagina causing the rectum to protrude into the vagina. In vaginal vault prolapse (uterine prolapse) the uterus intrudes into the vagina from above, and in enterocele the small intestine descends and protrudes into the vagina. 
         [0004]    One procedure for treating this type of disorder comprises securing the apex of the vagina to a sacrospinous ligament or other structurally supportive tissue within the pelvic region. In a majority of circumstances, anterior and posterior prolapses are directly caused by apical support defects. By supporting the vaginal apex region, most of the apically related prolapses of the vaginal area are relieved. 
         [0005]    Many conventional prolapse treatment procedures require an incision such as an open abdominal approach. In particular, these procedures include placing a mesh, graft, or other implant within the pelvic region of a patient. The mesh, graft, or other implant is delivered to the pelvic region through one or more vaginal incisions and/or through exterior incisions of the patient. Thus, this requires substantial surgery where a patient can be typically hospitalized for days after the surgery as part of their recovery. 
         [0006]    The foregoing examples of the related art and limitations related therewith are intended to be illustrative and not exclusive. Other limitations of the related art will become apparent to those of skill in the art upon a reading of the specification and a study of the figures. 
       SUMMARY 
       [0007]    The following embodiments and aspects thereof are described and illustrated in conjunction with systems, tools and methods which are meant to be exemplary and illustrative, not limiting in scope. 
         [0008]    Accordingly, a system and method for performing incision-less repairs of a prolapse in the pelvic region are highly desirable. The present invention provides a needle-based fixation solution combined with an optional soft tissue bonding agent. The present invention enables prolapse repair without surgical incision. Thus, the present invention eliminates the need for hospitalization post-surgery and general anesthesia during surgery. The present invention is directed toward further solutions to address these needs, in addition to having other desirable characteristics. 
         [0009]    In accordance with an embodiment of the present invention an incisionless transvaginal sacrospinous ligament fixation system has an anchoring unit configured to affix a vaginal wall to a sacrospinous ligament, a piercing tip that is configured to pierce the vaginal wall, at least partially pierce the sacrospinous ligament, and deploy a first portion of the anchoring unit through the pierced vaginal wall and the at least partially pierced sacrospinous ligament, thereby disposing the first portion at the sacrospinous ligament. 
         [0010]    In accordance with aspects of the present invention, the piercing tip is further comprised to deploy a second portion of the anchoring unit through the at least partially pierced sacrospinous ligament and through the pierced vaginal wall, wherein the second portion is disposed at an apex region of the vaginal wall, thereby affixing the vaginal wall to the sacrospinous ligament. 
         [0011]    In accordance with aspects of the present invention, the second portion is a suture that is configured to fasten to the apex region of the vaginal wall via a fastening mechanism. 
         [0012]    In accordance with aspects of the present invention, the first portion of the anchoring unit comprises a collapsible anchoring mechanism and the second portion of the anchoring mechanism comprises a stopper. 
         [0013]    In accordance with aspects of the present invention, the piercing tip is further configured with a delivery port for delivering a therapeutic substance. 
         [0014]    In accordance with aspects of the present invention, the system further comprises a first arm configured with a first anchoring unit and a first piercing tip, a second arm configured with a second anchoring unit and a second piercing tip, wherein the first arm and the second arm are further configured to grasp a portion of the vaginal wall that is positioned against the sacrospinous ligament, thereby surrounding the sacrospinous ligament. 
         [0015]    In accordance with aspects of the present invention, a suture is configured with both of the first anchoring unit and the second anchoring unit, wherein the first piercing tip is configured to deploy the suture through the first piercings of the sacrospinous ligament and the vaginal wall, and wherein the second piercing tip is further configured to deploy the suture through the second piercings of the sacrospinous ligament and the vaginal wall, and wherein the suture is disposed at an apex region of the vaginal wall, thereby affixing the vaginal wall to the sacrospinous ligament. 
         [0016]    In accordance with aspects of the present invention, a method for incisionless transvaginal sacrospinous ligament fixation includes piercing a vaginal wall, at least partially piercing a sacrospinous ligament, deploying a first portion of an anchoring unit through the pierced vaginal wall and the at least partially pierced sacrospinous ligament, thereby disposing the first portion at the sacrospinous ligament. 
         [0017]    In accordance with aspects of the present invention, the method further comprises deploying a second portion of the anchoring unit through the at least partially pierced sacrospinous ligament and through the pierced vaginal wall, wherein the second portion is disposed at an apex region of the vaginal wall, thereby affixing the vaginal wall to the sacrospinous ligament. 
         [0018]    In accordance with aspects of the present invention, the method further comprises deploying the second portion wherein the second portion is a suture that is configured to fasten to the apex region of the vaginal wall via a fastening mechanism. 
         [0019]    In accordance with aspects of the present invention, the method further comprises deploying the first portion wherein the first anchoring unit comprises a collapsible anchoring mechanism, and wherein deploying the second portion wherein the second portion comprises a stopper. 
         [0020]    In accordance with aspects of the present invention, the method further comprises delivering a therapeutic substance. 
         [0021]    In accordance with aspects of the present invention, the method further comprises grasping, via a first arm and a second arm, a portion of the vaginal wall that is positioned against the sacrospinous ligament, thereby surrounding the sacrospinous ligament, performing the piercing and deploying steps via the first arm, thereby affixing the vaginal wall to the sacrospinous ligament at a first location; and performing the piercing and deploying steps via the second arm, thereby affixing the vaginal wall to the sacrospinous ligament at a second location. 
         [0022]    In accordance with aspects of the present invention, the method further comprises deploying the second portion wherein the second portion is a suture that is disposed at the first and the second locations, and at an apex region of the vaginal wall, thereby affixing the vaginal wall to the sacrospinous ligament. 
         [0023]    In accordance with an embodiment of the present invention, an anchor delivery system has a delivery conduit having a wall forming an interior lumen, a first end, and a second end. The second end terminates with a delivery aperture. The anchor delivery system has an elongate cannula having a wall sized, dimensioned, and configured for slidable disposal within and along the interior lumen of the delivery conduit. The elongate cannula has an interior lumen, a first end, and a second end. The second end terminates with a tissue piercing tip and aperture. The anchor delivery system has one or more delivery ports disposed through the wall of the elongate cannula and proximal to the tissue piercing tip and aperture. The anchor delivery system has a pushrod sized, dimensioned, and configured for slidable disposal within and along the interior lumen of the elongate cannula. The anchor delivery system has a supply port into the interior lumen of the elongate cannula. The anchor delivery system has at least one anchor coupled with a suture. The anchor and suture are sized, dimensioned, and configured for slidable disposal within and along the interior lumen of the elongate cannula. The suture has a first end coupled to the anchor and a second end forming a loose tail. The anchor delivery system is arranged in such a way that the anchor and suture are disposed within the interior lumen of the elongate cannula. The elongate cannula is disposed within the interior lumen of the delivery conduit, and the pushrod is disposed within the interior lumen of the elongate cannula between the anchor and the first end of the elongate cannula. A push force applied to the pushrod causes the pushrod to slide through and push the anchor through and out the tissue piercing tip of the elongate cannula for implantation into tissue. 
         [0024]    In accordance with aspects of the present invention, the system further optionally includes a liquid or gel supplied to the interior lumen of the elongate cannula through the supply port. Upon removal of the pushrod from the interior lumen of the elongate cannula, the liquid or gel can exit the interior lumen of the elongate cannula through the one or more delivery ports and the tissue piercing tip and aperture. In one aspect, the liquid or gel is an adhesive. In a further aspect, the adhesive is bioglue. In another aspect, the liquid or gel is an agent that increases tissue ingrowth/inflammation. 
         [0025]    In accordance with aspects of the present invention, the pushrod is laterally flexible and axially rigid. In another aspect, the pushrod includes a handle. A push force is applied to the handle of the pushrod causing the pushrod to slide through and push the anchor through and out the tissue piercing tip and aperture of the elongate cannula for implantation into tissue. 
         [0026]    In accordance with aspects of the present invention, the supply port can be disposed through the wall of the elongate cannula into the interior lumen of the elongate cannula at a location distal from the tissue piercing tip and aperture. In accordance with aspects of the present invention, the one or more delivery ports can be positioned about 2 centimeters from each other along the wall of the elongate cannula. 
         [0027]    In accordance with aspects of the present invention, the anchor is bioabsorbable. In some aspects, the anchor coupled with the suture forms a T-shape when the anchor is implanted into tissue. In another aspect, the suture includes a plurality of barbs. 
         [0028]    In accordance with aspects of the present invention, a maximum distance between the first end of the delivery conduit and the first end of elongate cannula is between about 0.5 centimeters and about 1.5 centimeters. 
         [0029]    In accordance with an embodiment of the present invention, an anchor delivery system kit has a delivery conduit having a wall forming an interior lumen, a first end, and a second end. The second end terminates with a delivery aperture. The anchor delivery system kit has an elongate cannula having a wall sized, dimensioned, and configured for slidable disposal within and along the interior lumen of the delivery conduit. The elongate cannula has an interior lumen, a first end, and a second end. The second end terminates with a tissue piercing tip and aperture. The anchor delivery system kit has one or more delivery ports disposed through the wall of the elongate cannula and proximal to the tissue piercing tip and aperture. The anchor delivery system kit has a pushrod sized, dimensioned, and configured for slidable disposal within and along the interior lumen of the elongate cannula. The anchor delivery system kit has a supply port into the interior lumen of the elongate cannula. The anchor delivery system kit has at least one anchor coupled with a suture. The anchor and suture sized, dimensioned, and configured for slidable disposal within and along the interior lumen of the elongate cannula. The anchor delivery system kit is configurable in such a way that the anchor and suture are disposed within the interior lumen of the elongate cannula. The elongate cannula is disposed within the interior lumen of the delivery conduit. The pushrod is disposed within the interior lumen of the elongate cannula between the anchor and the first end of the elongate cannula. A push force applied to the pushrod causes the pushrod to slide through and push the anchor through and out the tissue piercing tip of the elongate cannula for implantation into tissue. 
         [0030]    In accordance with aspects of the present invention, upon removal of the pushrod from the interior lumen of the elongate cannula, a liquid or gel delivered through the supply port can exit the interior lumen of the elongate cannula through the one or more delivery ports and the tissue piercing tip and aperture. 
         [0031]    In accordance with an embodiment of the present invention, a method of using an anchor delivery system for incision-less fixation (e.g., sacrospinous) is provided. A vaginal apex region on a vaginal wall is located without making an incision. In accordance with aspects of the present invention, locating the vaginal apex region on the vaginal wall is based on tissue feedback. The vaginal apex region of the vaginal wall is positioned against (adjacent to) a sacrospinous ligament. The anchor delivery system is inserted through the vaginal opening to the vaginal apex region without making an incision. The vaginal apex region and the sacrospinous ligament are pierced through with the elongate cannula in a proximal to distal direction until the cannula reaches the external, distal surface of the sacrospinous ligament. The pushrod is actuated causing the anchor to slide through and out the tissue piercing tip of the elongate cannula to an anchoring location (e.g., on the external, distal surface of the sacrospinous ligament). The anchor delivery system is removed, leaving the anchor disposed in the anchoring location and the suture disposed through the sacrospinous ligament. The loose tail of the suture is anchored to the vaginal apex region of the vaginal wall. 
         [0032]    In accordance with aspects of the present invention, the elongate cannula of the anchor delivery system can be withdrawn, after actuating the pushrod, to a position between a proximal surface of the vaginal apex region and the external proximal surface of the sacrospinous ligament. A liquid or gel is supplied, using the anchor delivery system, between the external surface of the vaginal apex region and the external proximal surface of the sacrospinous ligament. In a further aspect, the liquid or gel is an adhesive. The adhesive can be bioglue. In another aspect, the liquid or gel is an agent that increases tissue ingrowth/inflammation. 
         [0033]    In accordance with aspects of the present invention, anchoring the loose tail of the suture to the vaginal apex region utilizes locking beads. 
         [0034]    In accordance with aspects of the present invention, the anchor is bioabsorbable. In another aspect, the first end of the suture is coupled to the anchor by bonding the first end of the suture to a portion of the anchor (e.g., a groove portion). 
         [0035]    In accordance with aspects of the present invention, the second end of the suture is coupled to a ring member of the anchor, e.g. the second end of the suture is threaded through the ring member of the anchor. The second end of the suture can be coupled to one or more anchors having a ring member by threading the second end through the ring member of each of the one or more anchors such that the suture connects each of the one or more anchors. 
         [0036]    In accordance with aspects of the present invention, the anchor can be an elongate member having a passageway disposed therethrough along the length of the anchor. In a further aspect, the first end of the suture is threaded through the passageway of the anchor to couple the first end of the suture to the anchor. The threaded first end of the suture is tied to a substantially central portion, between the first end and the second end, of the suture to form a loop. In another aspect, the loop takes on a substantially triangular shape when the anchor is implanted into tissue. The anchor forms the base of the substantially triangular shape. 
         [0037]    In accordance with an embodiment of the present invention, multiple anchors can be used to secure the vaginal wall to a sacrospinous ligament. The pushrod is actuated (e.g., actuated to a position sufficient to deploy a first anchor), causing a first anchor coupled with a suture to a second anchor to slide through and out the tissue piercing tip of the elongate cannula to a first anchoring location. The anchor delivery system is withdrawn from the distal surface to the proximal surface of the sacropinous ligament, leaving the first anchor disposed in the first anchoring location. The pushrod is actuated a second time (e.g., completing the actuation or deployment), causing the second anchor coupled with the suture to the first anchor to slide through and out the tissue piercing tip of the elongate cannula to a second anchoring location. The anchor delivery system is removed, leaving the first anchor disposed in the first anchoring location, the second anchor disposed in the second anchoring location, and a midsection, between the first anchor and the second anchor, of the suture disposed through the sacrospinous ligament. The midsection of the suture is anchored to the vaginal apex region of the vaginal wall. 
         [0038]    In accordance with an embodiment of the present invention, the anchor delivery system has an anchor having a base section and at least two wing portions affixed to the base section. The wing portions are configured to fold into a substantially straight line along the base section under an appropriate compression force. The anchor is sized, dimensioned, and configured for slidable disposal within and along the interior lumen of the elongate cannula. After the vaginal apex region and sacrospinous ligament is pierced through with the elongate cannula and the elongate cannula is slid from a proximal surface to a desired position on an external, distal surface of the sacrospinous ligament, the pushrod is actuated, causing the anchor to slide through and out the tissue piercing tip of the elongate cannula to an anchoring location. The two wing portions of the anchor unfold outwardly to form a substantially diamond-shape upon release of the compression force. The anchor delivery system is removed, leaving the anchor disposed in the anchoring location. The base section of the anchor is disposed through the sacrospinous ligament and the two wing portions are positioned against the external, distal surface of the sacrospinous ligament. A proximal end, with respect to the anchor delivery system, of the base of the anchor is anchored to the vaginal apex region of the vaginal wall. 
         [0039]    In accordance with an embodiment of the present invention, a method of using an anchor delivery system for incision-less sacrospinous fixation includes providing the anchor delivery system having a first arm and a second arm. The anchor delivery system has a first anchor positioned within the first arm and a second anchor positioned within the second arm. A vaginal apex region on the vaginal wall is located without making an incision. The anchor delivery system is inserted through a vaginal opening to the vaginal apex region without making anincision, The vaginal apex region of the vaginal wall is positioned against a sacrospinous ligament using the first arm and the second arm of the delivery system. The first anchor is implanted, using the first arm of the delivery system, into a first section of the vaginal wall proximal to the vaginal apex region and through the sacrospinous ligament. The second anchor is implanted, using the second arm of the delivery system, into a second section of the vaginal wall and proximal to the vaginal apex region and through the sacrospinous ligament. A suture is fastened between the first anchor and the second anchor. 
         [0040]    In addition to the exemplary aspects and embodiments described above, further aspects and embodiments will become apparent by reference to the figures and by study of the following detailed description. 
     
    
     
       BRIEF DESCRIPTION OF THE FIGURES 
         [0041]    Exemplary embodiments are illustrated in referenced figures. Dimensions of components and features shown in the figures are generally chosen for convenience and clarity of presentation and are not necessarily shown to scale. The figures are listed below. 
           [0042]      FIG. 1  is a perspective view of an anchor delivery system according to an embodiment of the present invention; 
           [0043]      FIG. 2  is a perspective view of the components of the anchor delivery system of  FIG. 1  according to one aspect of the present invention; 
           [0044]      FIG. 3  is a perspective view of an anchor coupled with a suture according to one aspect of the present invention; 
           [0045]      FIG. 4  is a sectional view of an elongate cannula disposed within a delivery conduit of the anchor delivery system according to one aspect of the present invention; 
           [0046]      FIG. 5A  is a sectional view of the elongate cannula of the anchor delivery system without a pushrod according to one aspect of the present invention; 
           [0047]      FIG. 5B  is a sectional view of the elongate cannula with a pushrod according to one aspect of the present invention; 
           [0048]      FIG. 6  is a perspective view of supply ports with different curvatures according to one aspect of the present invention; 
           [0049]      FIG. 7  is a cross-sectional view of the elongate cannula in use according to one aspect of the present invention; 
           [0050]      FIG. 8A  is a perspective view of an anchor coupled with a suture prior to deployment according to one aspect of the present invention; 
           [0051]      FIG. 8B  is a perspective view of the anchor/suture in  FIG. 8A  after deployment according to one aspect of the present invention;  FIGS. 9A-9B  are perspective views of the result of a first anchor procedure according to an embodiment of the present invention; 
           [0052]      FIG. 10  is a perspective view of two anchors coupled together by a suture after deployment according an embodiment of the present invention; 
           [0053]      FIGS. 11A-11B  are perspective views of the result of a second anchor procedure according to an embodiment of the present invention; 
           [0054]      FIG. 12A  is a perspective view of multiple anchors coupled together by a suture according to one aspect of the present invention; 
           [0055]      FIG. 12B  is a close-up view of the ring-member coupling the suture of  FIG. 12A  according to one aspect of the present invention; 
           [0056]      FIGS. 13A-13B  are perspective views of the result of a third anchor procedure according to an embodiment of the present invention; 
           [0057]      FIG. 14A  is a perspective view of another anchor coupled with a suture prior to deployment according to one aspect of the present invention; 
           [0058]      FIG. 14B  is a perspective view of the anchor/suture in  FIG. 14A  after deployment according to one aspect of the present invention; 
           [0059]      FIGS. 15A-15B  are perspective views of the results of a fourth anchor procedure according to an embodiment of the present invention; 
           [0060]      FIG. 16A  is a perspective view of a collapsible anchor prior to deployment according to an embodiment of the present invention; 
           [0061]      FIG. 16B  is a perspective view the collapsible anchor in  FIG. 16A  after deployment according to one aspect of the present invention; 
           [0062]      FIGS. 17A-17B  are perspective views of the result of a fifth anchor procedure according to an embodiment of the present invention; 
           [0063]      FIGS. 18A-18C  are perspective views of a sixth anchor procedure according to an embodiment of the present invention; 
           [0064]      FIG. 19  is a table depicting the results of the six anchor procedures; 
           [0065]      FIG. 20A  is perspective views of another anchor delivery system according to an embodiment of the present invention; 
           [0066]      FIG. 20B  is a perspective view of another anchor coupled with a suture after deployment according to one aspect of the present invention; 
           [0067]      FIG. 21  is a close-up view of a proximal end of the anchor delivery system of  FIG. 20A  according to one aspect of the present invention; 
           [0068]      FIG. 22  is a close-up view of a distal end of the anchor delivery system of  FIG. 20A  according to one aspect of the present invention; 
           [0069]      FIG. 23  is perspective views of the anchor delivery system of  FIG. 20A  in use according to aspects of the present invention; 
           [0070]      FIG. 24A  is a close-up cross-sectional view of a proximal end of the anchor delivery system of  FIG. 20A  according to one aspect of the present invention; 
           [0071]      FIG. 24B  is a close-up cross-sectional view of a distal end of the anchor delivery system of  FIG. 20A  in use according to an embodiment of the present invention; 
           [0072]      FIG. 25A  is a microscopic view of an anchor/suture shortly after deployment according to one aspect of the present invention; 
           [0073]      FIG. 25B  is a microscopic view of the anchor/suture of  FIG. 25A  when the suture is pulled in a particular direction according to one aspect of the present invention; 
           [0074]      FIG. 26  is a perspective views of another anchor delivery system according to an embodiment of the present invention; 
           [0075]      FIG. 27  is perspective views of the operation of the anchor delivery system of  FIG. 26  according to one aspect of the present invention. 
           [0076]      FIG. 28  is a perspective view of an anchor coupled with a barbed suture according to one aspect of the present invention; 
           [0077]      FIG. 29  is a perspective view of an anchor coupled with a washer according to one aspect of the present invention; 
           [0078]      FIG. 30  is a perspective view of an anchor coupled with a corrugated washer according to one aspect of the present invention; and 
           [0079]      FIG. 31  is a perspective view of an anchor coupled with a suture configured with one or more tines, according to one aspect of the present invention. 
       
    
    
     DETAILED DESCRIPTION 
       [0080]    An illustrative embodiment of the present invention relates to an anchor delivery system and method of use. In general, the anchor delivery system integrates an anchor with a specific needle or syringe type device. This anchor delivery system facilitates tissue fixation and enhances scarring and long-term fixation. Although the system is particularly described for use in methods for sacrospinous fixation, it will be understood that the invention is not so limited and can be used in other tissue fixation contexts. 
         [0081]      FIGS. 1 through 31 , wherein like parts are designated by like reference numerals throughout, illustrate an anchor delivery system and a method of use according to the present invention. Although the present invention will be described with reference to the figures, it should be understood that many alternative forms can embody the present invention. One of ordinary skill in the art will additionally appreciate different ways to alter the parameters disclosed, such as the size, shape, or type of elements or materials, in a manner still in keeping with the spirit and scope of the present invention. 
         [0082]      FIGS. 1-2  illustrate the anchor delivery system  10 .  FIG. 1  depicts an example anchor delivery system  10  in constructed form. Alternatively,  FIG. 2  depicts the separate components of the anchor delivery system or an example of an anchor delivery system kit. 
         [0083]    The anchor delivery system  10  has a delivery conduit  12  having a wall forming an interior lumen  11 A, a first end  15 A, and a second end  17 A. The second end  17 A terminates with a delivery aperture  14 . The delivery conduit  12  can be an outer sheath or a catheter structure. The delivery conduit  12  can include a gripper section  13  for allowing a user to hold the anchor delivery system  10 , particularly the delivery conduit  12 . 
         [0084]    The anchor delivery system  10  has an elongate cannula  18  having a wall sized, dimensioned, and configured for slidable disposal within and along the interior lumen  11 A of the delivery conduit  12 . The elongate cannula  18  has an interior lumen  11 B, a first end  15 B, and a second end  17 B. The second end  17 B terminates with a tissue piercing tip and aperture  16 . The elongate cannula  18  can be retracted a certain distance from the delivery conduit  12 . In particular, a maximum distance of L between the first end  15 A of the delivery conduit  12  and the first end  15 B of the elongate cannula  18  may be between about 0.5 centimeters and 1.5 centimeters. The distance of L is meant to provide depth control such that the elongate cannula  18  can only be delivered a certain distance beyond the delivery conduit  12 . Other variations of distances may be contemplated by one of skill in the art to provide depth control. In one example, the elongate cannula  18  has a needle-type structure. The elongate cannula  18  can have a pusher section  19  that provides a place for a user to push or place pressure on the elongate cannula  18  during use of the anchor delivery system  10 . The pusher section  19  provides a location for a user to grasp and retract the elongate cannula  18  when desired. 
         [0085]    The anchor delivery system  10  has a pushrod  20  that is sized, dimensioned, and configured for slidable disposal within and along the interior lumen  11 B of the elongate cannula  18 . The pushrod  20  can include a handle  21  at a distal end of the pushrod  20  with respect to the delivery aperture  14  and tissue piercing tip and aperture  16 . The pushrod  20  can be laterally flexible and axially rigid in use with the anchor delivery system  10 . 
         [0086]    The anchor delivery system  10  includes an anchoring unit comprising two portions. The first portion, such as an implant which can be an anchor  24  is coupled with a second portion, a suture  26  as shown in  FIGS. 2 and 3 . The anchor  24  and suture  26  are sized, dimensioned, and configured to be slidably disposed within and along the interior lumen  11 B of the elongate cannula  18 . The anchor can be biodegradable, bioabsorbable, or both. Alternatively, the anchor can be made from a material that is permanent and does not degrade in vivo. Additionally, as illustrated in the examples of  FIGS. 28 and 31 , the suture  26  can include barbs or tines  26 A, respectively, along the length of the suture  26 . 
         [0087]    The anchor delivery system  10  is arranged in such a way that the anchor  24  and suture  26  are disposed within the interior lumen  11 B of the elongate cannula  18 . The elongate cannula  18  is disposed within the interior lumen  11 A of the delivery conduit  12 , and the pushrod  20  is disposed within the interior lumen  11 B of the elongate cannula  18  between the anchor  24  and the first end  15 B of the elongate cannula  18 . A push force applied to the pushrod  20 , such as the handle  21  of the pushrod  20 , causes the pushrod  20  to slide through and deploy the anchor  24  by pushing it through and out of the tissue piercing tip and aperture  16  for implanting at the ligament. 
         [0088]      FIG. 4  depicts a sectional view of the elongate cannula  18  disposed within the delivery conduit  12 . In use, the tissue piercing tip and aperture  16  of the elongate cannula  18  can slide along the interior lumen  11 A and out through the delivery aperture  14  of the delivery conduit  12 . One or more delivery ports  28  can be disposed through the wall of the elongate cannula  18  and proximal to the tissue piercing tip and aperture  16  as shown in  FIGS. 5A-5B  for delivering a liquid or gel. The delivery ports  28  may be positioned about 2 centimeters from each other along the wall of the elongate cannula  18 .  FIG. 5B  depicts the arrangement of the pushrod  20  within the elongate cannula  18  illustrating how the pushrod  20  functions with the elongate cannula  18  in deploying an anchor from the elongate cannula  18 . 
         [0089]    As shown in  FIGS. 1 and 2 , the anchor delivery system  10  can have a supply port  22  that is attached into the interior lumen  11 B of the elongate cannula  18 . In particular, the supply port  22  can be disposed through the wall of the elongate cannula  18  into the interior lumen  11 B of the elongate cannula  18  at a location that is distal from the tissue piercing tip and aperture  16 . A therapeutic substance, such as a liquid or gel, is supplied to the interior lumen  11 B of the elongate cannula  18  through the supply port  22 . In another example, the anchor delivery system  10  does not have a supply port  22  and the liquid or gel can be supplied directly to the interior lumen  11 B of the elongate cannula  18 . Upon removal of the pushrod  20  from the interior lumen  11 B of the elongate cannula  18  as shown in  FIG. 5A , the liquid or gel can be delivered through the supply port  22  or directly to and through the elongate cannula  18  and can exit the interior lumen  11 B of the elongate cannula  18  through the one or more delivery ports  28  (shown in  FIGS. 4-5B ) and the tissue piercing tip and aperture  16 . In one example, the liquid or gel can be an adhesive or glue. In particular, the adhesive may be bioglue (biological glue). Alternatively, the liquid or gel is mesh fluid, sprayed fibrin/thrombin glue, TissuGlu® by Cohera Medical, Inc., etc. In another example, the liquid or gel is an agent that increases tissue ingrowth/inflammation and increases tissue planes. Other properties of the fluid or gel may include biocompatibility, tolerance in a pravaginal/paravesical/pararectal spaces, dual characteristics as scaffold to enable ingrowth and glue for short-term adherence, ease of injection, thick/viscous enough to remain in location of injection, and thin/fluid enough to allow for distribution at injection site enabling broad area of adherence.  FIG. 6  depicts supply ports  22 A- 22 F with different curvatures. In particular, the supply ports  22 A- 22 F have curvature angles at one end ranging from about 0 degrees or straight (supply port  22 A) to about 90 degrees (supply port  22 D) to about 180 degrees (supply port  22 F). 
         [0090]      FIG. 7  depicts a cross-sectional view of the elongate cannula  18  in use with an anchor or implant. In this example, the anchor  24  includes a portion such as a groove portion  30  such that a suture  26  is coupled to the anchor  24  by bonding of one end of the suture  26  to the groove portion  30 . The anchor may be attached by alternative means than direct bonding. A pushrod  20  is inserted or disposed within the interior lumen  11 B of the elongate cannula  18  such that the pushrod  20  engages the groove portion  30  of the anchor. This allows for the pushrod  20  to force the anchor  24  through the elongate cannula  18  and out of the tissue piercing tip and aperture  16 . 
         [0091]      FIG. 8A  depicts an anchoring unit comprising two portions prior to deployment. A first portion, anchor  24 , is configured with the groove portion  30  of  FIG. 7  and coupled with a second portion, suture  26 . For example, the anchor  24  with the attached suture  26  forms this configuration while disposed in the elongate cannula  18  prior to deployment.  FIG. 8B  depicts the anchor  24  coupled with the suture  26  after deployment in a tissue. In this example, the anchor  24  coupled with the suture  26  forms a T-shape when the anchor  24  is implanted or deployed into the tissue. 
         [0092]      FIGS. 9A-9B  depict the result of a first anchor procedure. This first anchor procedure is a method of using the anchor delivery system  10  for incision-less sacrospinous fixation. This first anchor procedure includes providing the anchor delivery system  10  as described above. As shown in  FIG. 7 , the anchor  24  and suture  26  are sized, dimensioned, and configured for slidable disposal within and along the interior lumen  11 B of the elongate cannula  18 . As shown in  FIGS. 8A-8B , the suture  26  has one end coupled to the anchor  24  and another end forming a loose tail. 
         [0093]    In this first anchor procedure, a vaginal apex region  32  on a vaginal wall  33  of the vagina is located without making any incisions. In particular, the vaginal apex region  32  can be located based on tissue feedback. The vaginal apex region  32  is positioned against the sacrospinous ligament  34 . The anchor delivery system  10  is inserted through the vaginal opening to the vaginal apex region  32  without making any incisions. The piercing tip and aperture  16  of the elongate cannula  18  pierces through the vaginal apex region  32  and is slid from a proximal surface to a desired position on an external, distal surface of the sacrospinous ligament  34 . Alternatively, the piercing tip and aperture  16  at least partially pierce the sacrospinous ligament  34  to deploy the anchor through the pierced vaginal wall and through the at least partially pierced sacrospinous ligament  34 . 
         [0094]    A user can slide the pushrod  20  to cause the anchor  24  to slide through and out of the tissue piercing tip and aperture  16  to an anchoring location near the desired position. When the anchor delivery system  10  is removed, it leaves the anchor  24  disposed in the anchoring location and the suture  26  disposed through the sacrospinous ligament  34  as shown in  FIGS. 9A-9B . The loose tail of the suture  26  is anchored to the vaginal apex region  32  of the vaginal wall. For example, the loose tail of the suture  26  can be anchored to the vaginal apex region  32  by using any know fastening mechanism, such as one or more locking beads  36 . Additionally, as depicted in  FIGS. 29 and 30 , suture  26  may be anchored to the vaginal apex region  32  using a washer type mechanism  26 B. 
         [0095]    This first anchor procedure may further include withdrawing the elongate cannula  18  to a position between the external surface of the vaginal apex region  32  and the external, proximal surface of the sacrospinous ligament  34  (a space between the vaginal apex region  32  and sacrospinous ligament  34 ). Using the anchor delivery system  10 , a liquid or gel is supplied to this space, between the external surface of the vaginal apex region  32  and the external, proximal surface of the sacrospinous ligament  34 . The liquid or gel can be an adhesive such as biological glue. In another example, the liquid or gel can be an agent that increases tissue ingrowth/inflammation at this site between the external surface of the vaginal apex region  32  and the external, distal surface of the sacrospinous ligament  34 . 
         [0096]      FIG. 10  depicts two anchors  24  coupled together by a suture  26  in a configuration after deployment of the two anchors  24 . In this example, two anchors  24  are attached to each other by a suture  26  enabling a partial loop to be formed between the two anchors  24  after deployment of each. This formation is further depicted in  FIGS. 11A-11B  illustrating results of a second anchor deployment procedure. Similar to the first anchor procedure, an anchor delivery system  10  as described above is initially provided. The two anchors  24  attached with the suture  26  are sized, dimensioned, and configured for slidable disposal within and along the interior lumen  11 B of the elongate cannula  18 . 
         [0097]    Similar to the first anchor procedure, a vaginal apex region  32  on the vaginal wall  33  of the vagina is located without making any incisions. In particular, the vaginal apex region  32  can be located based on tissue feedback. The vaginal apex region  32  is positioned against the sacrospinous ligament  34 . The anchor delivery system  10  is inserted through the vaginal opening to the vaginal apex region  32  without making any incisions. The piercing tip and aperture  16  of the elongate cannula  18  pierces through the vaginal apex region  32  and is slid from a proximal surface of the sacrospinous ligament to a desired position on an external, distal surface of the sacrospinous ligament  34 . 
         [0098]    A user can slide the pushrod  20  to cause one anchor  24  (i.e., first anchor) coupled with the suture  26  to a second anchor  24  to slide through and out of the tissue piercing tip and aperture  16  to a first anchoring location. The anchor delivery system  10  is withdrawn from the distal surface to the proximal surface of the sacrospinous ligament  34 , leaving the first anchor  24  disposed in the first anchoring location. The pushrod is actuated or slid, causing the second anchor  24  coupled with the suture  26  to the first anchor  24  to slide through and out the tissue piercing tip and aperture  26  to a second anchoring location. When the anchor delivery system  10  is removed, it leaves one anchor  24  disposed in location, and a midsection  38 , between the two anchors  24  as shown in  FIG. 10 , of the suture  26  disposed through the sacrospinous ligament  34  as shown in  FIGS. 11A-11B . In particular, the midsection  38  of the suture  26  is anchored to the vaginal apex region  32  of the vaginal wall. 
         [0099]      FIG. 12A  depicts multiple anchors  24  coupled together by a suture  26  and ring members  40 . In this example, a first end  42  of the suture  26  is coupled to one of the anchors  24 . The coupling of the first end  42  can include direct attachment (shown in  FIG. 12A ) to the anchor  24  or coupling via a ring member  40  of an anchor  24 . The second end  44  of the suture  26  or loose end is coupled to a ring member  40  of at least one other anchor  24 . In particular, the second end  44  of the suture  26  is threaded through the ring member  40  of the anchor  24  as shown in  FIG. 12B . The threaded second end  44  of the suture  26  can then be coupled to additional anchors  24  having ring members  40  by threading the threaded second end  44  through the ring member  40  of each of the additional anchors  24  such that the suture  26  can connect each of the additional anchors  24  (i.e., by forming a partial loop  46 ) as shown in  FIG. 12A . The second end  44  of the suture  26  can be pulled for tightening of the suture  26  across the multiple anchors  24 . 
         [0100]      FIGS. 13A-13B  depict the result of a third anchor procedure incorporating the multiple anchors  24 /ring members  40  configuration shown in  FIGS. 12A-12B  and described above. The third anchor procedure is similar to the first and second anchor procedures described above. In the third anchor procedure, the multiple anchors  24  with ring members  40  coupled to the suture  26  are sized, dimensioned, and configured for slidable disposal within and along the interior lumen  11 B of the elongate cannula  18 . In one example, a group of multiple anchors coupled to the suture via ring members may be disposed within the elongate cannula as a group prior to deployment. Alternatively, the multiple anchors with ring members coupled to a suture or not coupled to a suture can be separately disposed within the elongate cannula  18  prior to deployment. The piercing tip and aperture  16  of the elongate cannula  18  is slid from a proximal surface to a desired position on an external, distal surface of the sacrospinous ligament  34 . 
         [0101]    A user can then slide the pushrod  20  to cause the group of multiple anchors  24  with ring members  40  coupled to the suture  26  to slide through and out of the tissue piercing tip and aperture  16  to 
         [0102]    Alternatively, the user can slide the pushrod  20  to cause each of the multiple anchors  24  with ring members  40  coupled to the suture  26  or not coupled to the suture  26  to separately or individually slide through and out of the tissue piercing tip and aperture  16 . This can be repeated multiple times to position the multiple anchors  24  at multiple anchoring locations on the sacrospinous ligament  34 . When the anchor delivery system  10  is removed, the anchor delivery system  10  leaves multiple anchors  24  disposed in multiple anchoring locations with loops  46  between each of the anchors  24  as shown in  FIGS. 13A-13B . The loops  46  of the suture  26  can be disposed through the sacrospinous ligament  34 . The second end  44  or loose tail of the suture  26  is anchored proximally to the vaginal apex region  32  of the vaginal wall. For example, the second end  44  of the suture  26  can be anchored proximally to the vaginal apex region  32  by using locking beads  36 . 
         [0103]      FIG. 14A  depicts another anchor embodiment coupled with a suture  26  prior to deployment. This anchor  24  is an elongate member having a passageway disposed through the anchor  24  along the length of the anchor  24 . A first end  42  of the suture  26  is threaded through the passageway of the anchor  24  coupling the first end  42  of the suture  26  to the anchor  24 . The threaded first end  42  of the suture  26  is tied to a substantially central portion, between the first end  42  and the second end  44  of the suture  26 . In particular, the threaded first end  42  is tied into a knot  48  at the substantially central portion. The anchor  24  coupled with the suture  26  as described above can form a substantially elongate loop  47 . In one example, this configuration of the anchor  24  coupled to the suture  26  to form the elongate loop  47  can be disposed in the elongate cannula  18  prior to deployment.  FIG. 14B  depicts the anchor  24  coupled to the suture  26  in  FIG. 14A  after deployment in a tissue for example. In this example, the elongate loop  47  takes on or assumes a substantially triangular shape when the anchor  24  is implanted or deployed into tissue. In particular, the anchor  24  forms the base of the substantially triangular shape as shown in  FIG. 14  B. 
         [0104]      FIGS. 15A-15B  depict the result of a fourth anchor procedure incorporating the anchor  24 /suture  26  configuration shown in  FIGS. 14A-14B  and described above. The fourth anchor procedure is similar to the first anchor procedure described above. In the fourth anchor procedure, the anchor  24  coupled to the suture  26  is sized, dimensioned, and configured for slidable disposal within and along the interior lumen  11 B of the elongate cannula  18  as shown prior to deployment in  FIG. 14A . The piercing tip and aperture  16  of the elongate cannula  18  is slid from a proximal surface to a desired position on an external, distal surface of the sacrospinous ligament  34 . A user can slide the pushrod  20  to cause the anchor  24 /suture  26  to slide through and out of the tissue piercing tip and aperture  16  to an anchoring location near the desired position. When the anchor delivery system  10  is removed, it leaves the anchor  24  disposed in the anchoring location and the second end portion  50  (i.e., loose tail) of the suture  26  disposed through the sacrospinous ligament  34  as shown in  FIG. 9B . This loose tail or second end portion  50  of the suture  26  is anchored to the vaginal apex region  32  of the vaginal wall, such as via any suitable fastening mechanism. In one example, the second end portion  50  of the suture  26  can be anchored to the vaginal apex region  32  by using locking beads  36 . 
         [0105]      FIG. 16A  depicts a collapsible anchoring mechanism, such as collapsible anchor  52  prior to deployment.  FIG. 16B  depicts the collapsible anchor in  FIG. 16A  after deployment. The collapsible anchor  52  is substantially flexible enabling the collapsible anchor  52  to change shape from a formation prior to deployment to a deployed formation. The collapsible anchor  52  has a base section  54  and at least two wing portions  56  affixed to the base section  54 . The wing portions  56  are configured to fold into a substantially straight line along the base section  54  as shown in  FIG. 16A  under suitable compression force, prior to deployment. This allows for the collapsible anchor  52  to be disposed in the elongate cannula  18  prior to deployment.  FIG. 16B  depicts the collapsible anchor  52  in a formation after deployment. In this example, the two wing portions  56  of the collapsible anchor  52  unfold outwardly from the base section  54  to form a substantially diamond-shape. The collapsible anchor  52  includes a stopper section  57  at the bottom of the base section  54  for anchoring to a tissue. 
         [0106]      FIGS. 17A-17B  depict the result of a fifth anchor procedure incorporating the collapsible anchor  52  shown in  FIGS. 16A-16B  and described above. The fifth anchor procedure is similar to the first anchor procedure described above. However, this example procedure or result does not include a suture. In the fifth anchor procedure, the collapsible anchor  52  is sized, dimensioned, and configured for slidable disposal within and along the interior lumen  11 B of the elongate cannula  18  as shown prior to deployment in  FIG. 16A . The vaginal apex region and sacrospinous ligament is pierced through by the piercing tip and aperture  16  of the elongate cannula  18  and the elongate cannula  18  is slid to a desired position on an external, distal surface of the sacrospinous ligament  34 . A user can slide the pushrod  20  to cause the collapsible anchor  52  to slide through and out of the tissue piercing tip and aperture  16  to an anchoring location near the desired position. The two wing portions  56  of the collapsible anchor  52  unfold outwardly to form a substantially diamond-shape upon exiting the tissue piercing tip and aperture  16  of the elongate cannula  18 . When the anchor delivery system  10  is removed, it leaves the collapsible anchor  52  disposed in the anchoring location. In particular, the base section  54  of the collapsible anchor  52  is disposed through the sacrospinous ligament  34  and the two wing portions  56  are positioned against the external, distal surface of the sacrospinous ligament  34  as shown in  FIGS. 17A-17B . A distal end  58 , with respect to the sacrospinous ligament  34 , of the base section  54  of the collapsible anchor  52  is anchored to the vaginal apex region  32  of the vaginal wall. In particular, the stopper section  57  can be used at the distal end  58  for anchoring the base section  54  to the vaginal apex region  32 . 
         [0107]      FIGS. 18A-18C  depict a sixth anchor procedure. Similar to the procedures described above, the sixth anchor procedure is a method of using an anchor delivery system for incision-less sacrospinous fixation. Initially, a grasper anchor delivery device  60  or grabber device is provided. The grasper anchor delivery device  60  has a first arm  62 A and a second arm  62 B. A first anchor  24 A is positioned within the first arm  62 A and a second anchor  24 B is positioned within the second arm  62 B. As similarly described above, the vaginal apex region  32  on the vaginal wall  33  is located without making any incisions. The grasper anchor delivery device  60  is inserted through the vaginal opening to the vaginal apex region  32  without making any incisions. The vaginal apex region  32  of the vaginal wall  33  is positioned against the sacrospinous ligament  34  using the first arm  62 A and the second arm  62 B. In particular, the first arm  62 A and second arm  62 B grasp a portion of the vaginal wall  33  proximal the vaginal apex region  32  and surround the sacrospinous ligament  34  as shown in  FIG. 18A . The first anchor  24 A is implanted, using a first piercing tip configured with the first arm  62 A of the grasper anchor delivery device  60 , to a first section of the vaginal wall, proximal to the vaginal apex region  32 , through the sacrospinous ligament  34 , as described above with respect to  FIGS. 1-17B . 
         [0108]    Similarly, the second anchor  24 B is implanted, using a second piercing tip configured with the second arm  62 B of the grasper anchor delivery device  60 , to a second section of the vaginal wall  33 , proximal to the vaginal apex region  32 , through the sacrospinous ligament  34 . A suture  26  is fastened between the first anchor  24 A and the second anchor  24 B through the sacrospinous ligament  34  as shown in  FIGS. 18A-18B . Alternatively, the suture  26  can be fastened prior to deployment of the first anchor  24 A and the second anchor  24 B. The upper figure of  FIG. 18B  depicts the position of the vaginal apex region  32  with respect to the sacrospinous ligament  34  when the first anchor  24 A and second anchor  24 B are being implanted or deployed by the grasper anchor delivery device  60 . The lower figure of  FIG. 18B  depicts the position of the vaginal apex region  32  with respect to the sacrospinous ligament  34  after the first anchor  24 A and second anchor  24 B are implanted.  FIG. 18C  depicts the position of the vaginal apex region  32  with respect to the sacrospinous ligament  34  based on the forces, as shown by the arrows, provided by the grasper anchor delivery device  60  and anchors  24 A,  24 B/suture  26  during implanting (upper figure) and after implanting (lower figure). 
         [0109]      FIG. 19  is a table depicting the results of the six anchor procedures discussed above. In particular, the table illustrates embodiments 1-6 which correlate with the results of anchor procedures one through six respectively. 
         [0110]      FIG. 20A  depicts another anchor delivery system  10 ′ having essentially the same components compared to the anchor delivery system  10  in  FIG. 1 . The anchor delivery system  10 ′ has a slightly varied design. In general, the anchor delivery system  10 ′ has a delivery conduit  12 , elngate cannula  18 , and pushrod  20  having similar functions and interactions as described above.  FIG. 20B  depicts another anchor  24  coupled with a suture  26 , similar to the anchor  24 /suture  26  of  FIG. 3 , after deployment by the anchor delivery system  10 ′. 
         [0111]      FIG. 21  depicts a proximal end of the anchor delivery system  10 ′ of  FIG. 20A . Similar to the anchor delivery system  10  in  FIG. 1 , the anchor delivery system  10 ′ includes a delivery conduit  12  with a gripper section  13 . In particular, the gripper section  13  is a finger grip surrounding the delivery conduit  12 . The anchor delivery system  10 ′ has an elongate cannula  18  with a pusher section  19 . In this example, the supply port  22  is configured or molded into the pusher section  19  of the elongate cannula  18  for delivering or injecting a liquid or gel such as an adhesive. The anchor delivery system  10 ′ includes pushrod  20  that is used for deploying an anchor or implant. A suture  26  can be positioned through an interior lumen of the pushrod  20 . This suture  26  attaches to an anchor  24  inside the elongate cannula  18 . 
         [0112]      FIG. 22  depicts a distal end of the anchor delivery system  10 ′ of  FIG. 20A . Similar to  FIG. 4 , the anchor delivery system  10 ′ has an elongate cannula  18  disposed within the delivery conduit  12 . One or more delivery ports  28  are disposed through the wall of the elongate cannula  18  and proximal to the tissue piercing tip and aperture  16  for delivering a liquid or gel such as adhesive. 
         [0113]      FIG. 23  depicts the anchor delivery system  10 ′ of  FIG. 20A  in use. In particular,  FIG. 23  illustrates how use of the proximal end in  FIG. 21  impacts the function of the components of the distal end in  FIG. 22 . Initially, the elongate cannula  18  is completely retracted and the pushrod  20  is completely retracted. Then, the pusher section  19  is pushed forward causing the elongate cannula  18  to slide forward and beyond the delivery conduit  12  to a desired position on a tissue such as the sacrospinous ligament. The pushrod  20  is pushed forward to engage an anchor  24 /suture  26  causing the anchor  24 /suture  26  to slide through and out of the tissue piercing tip and aperture  16  of the elongate cannula  18  to an anchoring location. As shown in  FIG. 23 , this procedure allows for the anchor delivery system  10 ′ to deploy or implant the anchor  24 . 
         [0114]      FIG. 24A  depicts a proximal end of the anchor delivery system  10 ′ of  FIG. 20A .  FIG. 24B  depicts a distal end of the anchor delivery system  10 ′ of  FIG. 20A  in use. In particular,  FIGS. 24A-24B  illustrate the process of delivery the liquid or gel. As shown in  FIG. 24A , a liquid or gel is supplied to the interior lumen  11 B of the elongate cannula  18  through the supply port  22 . In particular, the liquid or gel, such as glue, is injected using a syringe and tube to the supply port  22 . A liquid flow LF is shown from the supply port  22  through the pusher section  19  and through the elongate cannula  18  and the delivery conduit  12 . The liquid flow LF continues through the distal end of the anchor delivery system  10 ′. In particular, liquid or gel can exit the interior lumen  11 B of the elongate cannula  18  through one or more delivery ports  28  that are disposed through the wall of the elongate cannula  18  and proximal to the tissue piercing tip and aperture  16  as described above. A stopper  64  can be provided at the distal end of the elongate cannula  18  to prevent accidental delivery of glue from the tissue piercing tip and aperture  16 . 
         [0115]      FIG. 25A  depicts a microscopic view of the anchor  24 /suture  26  shortly after deployment at a tissue such as the sacrospinous ligament. As the suture  26  is pulled in a direction away from the anchor  24 , as shown in  FIG. 25B , it causes the anchor  24 /suture  26  to form the T-shape which allows for the anchor  24  to maintain its position in holding a particular organ/tissue in place. 
         [0116]      FIG. 26  depicts another anchor delivery system  10 ″ having essentially the same components compared to the anchor delivery systems  10  in  FIG. 1  and the anchor delivery system  10 ′ in  FIG. 20A . This anchor delivery system  10 ″ has a slightly varied design. The anchor delivery system  10 ″ has a delivery conduit  12 , gripper section  13  of the delivery conduit  12 , elongate cannula  18 , pushrod  20 , and supply port  22  having similar functions and interactions as described above. Additionally, the anchor delivery system  10 ″ has a first lock  66 A and a second lock  66 B. The first lock  66 A is at a first end  15 A of the delivery conduit  12  for preventing accidental exposure of the tissue piercing tip and aperture  16  before positioning of the anchor delivery system  10 ″. In particular, the first lock  66 A can be pushed inward to obstruct an interior lumen of the delivery conduit  12  thus preventing the elongate cannula  18  from being able to slide along towards the delivery aperture  14  of the delivery conduit  12 . When the first lock  66 A is pulled outward, it unlocks the first lock  66 A allowing for the elongate cannula  18  to be able to slide within the delivery conduit  12 . The second lock  66 B is at the top of the pushrod  20  for preventing accidental delivery or deployment of an anchor  24  prior to inserting of the elongate cannula  18 . This second lock  66 B is in line or parallel with the gripper section  13  as shown in  FIG. 26 , when in a locked position. In the locked position, the second lock  66 B prevents the pushrod  20  from being able to slide in the elongate cannula  18 . 
         [0117]    However, when the second lock  66 B is rotated clockwise or counter clockwise such that the second lock  66 B is no longer parallel with the gripper section, the second lock  66 B is unlocked allowing for the pushrod  20  to slide within and along the interior lumen of the elongate cannula  18  to deploy/insert an anchor  24 . The pushrod  20  has a thumb pad  68  for ease of use for a user pushing on the pushrod  20 . 
         [0118]      FIG. 27  depicts the operation of the anchor delivery system  10 ″ of  FIG. 26 . In particular, the top three drawings illustrate the process of inserting the anchor delivery system  10 ″ into a tissue and the bottom two drawings illustrate the process of deploying the anchor delivery system  10 ″. In step  1 , the anchor delivery system  10 ″ is inserted into a vagina for example. In step  2 , the first lock  66 A is unlocked by a user using their thumb for example to pull out the first lock  66 A to an unlocked position. In step  3 , a user pushes the elongate cannula  18  such that the tissue piercing tip and aperture  16  is inserted into a tissue. In step  4 , the second lock  66 B is rotated in either a clockwise or counter clockwise direction to unlock the second lock  66 B. In step  5 , the pushrod  20  is pushed to deploy an anchor into tissue. 
         [0119]    Numerous modifications and alternative embodiments of the present invention will be apparent to those skilled in the art in view of the foregoing description. Accordingly, this description is to be construed as illustrative only and is for the purpose of teaching those skilled in the art the best mode for carrying out the present invention. Details of the structure may vary substantially without departing from the spirit of the present invention, and exclusive use of all modifications that come within the scope of the appended claims is reserved. Within this specification embodiments have been described in a way which enables a clear and concise specification to be written, but it is intended and will be appreciated that embodiments may be variously combined or separated without parting from the invention. It is intended that the present invention be limited only to the extent required by the appended claims and the applicable rules of law. 
         [0120]    It is to be understood that the following claims are to cover all generic and specific features of the invention described herein, and all statements of the scope of the invention which, as a matter of language, might be said to fall therebetween.