A fixation system for engaging tissue comprising: an implantable fixation device comprising a pair of fixation elements (18A, 18B) each having a first end, a free end opposite the first end, and an engagement surface therebetween for engaging the tissue, the first ends being movably coupled together such that the fixation elements (18A, 18B) are moveable between a closed position wherein the engagement surfaces face each other to a first open position wherein the engagement surfaces are positioned away from each other; an actuation mechanism coupled to the fixation elements (18A, 18B) adapted to move the fixation elements (18A, 18B) between the closed position and the first open position; and a pair of gripping elements (16A, 16B) comprising a first gripping element and a second gripping element, each of the gripping elements (16A, 16B) moveable with respect to one of the fixation elements (18A, 18B) and configured to be moved in opposition to one of the engagement surfaces so as to capture tissue therebetween; a gripper actuator releasably coupled to the implantable fixation device and configured to individually actuate the gripping elements (16A, 16B) comprising a first gripper actuator releasably coupled to the implantable fixation device and configured to actuate the first gripping element, the first gripper actuator having a first configuration and a second configuration, wherein actuating the first gripper actuator between the first configuration and the second configuration moves the first gripping element with respect to the first fixation element, a second gripper actuator releasably coupled to the implantable fixation device and configured to actuate the second gripping element, the second gripper actuator having a first configuration and a second configuration, wherein actuating the second gripper actuator between the first configuration and the second configuration moves the second gripping element with respect to the second fixation element; an elongate delivery shaft having a proximal portion and a distal portion, wherein the distal portion is releasably coupled to the proximal portion of the implantable fixation device, wherein the first gripper actuator and the second gripper actuator are actuatable between the first configuration and the second configuration independently of each other, said system being characterized in that the or each gripper actuator (90, 90A, 90B) comprises a gripper line that extends from the proximal end of the delivery shaft and is coupled to each of the first gripping element and the second gripping element at portions of the gripper line between the proximal end of the delivery shaft and releasably coupled to at least one of the proximal end of the implantable fixation device or the distal end of the elongate delivery shaft. an implantable fixation device comprising a pair of fixation elements (18A, 18B) each having a first end, a free end opposite the first end, and an engagement surface therebetween for engaging the tissue, the first ends being movably coupled together such that the fixation elements (18A, 18B) are moveable between a closed position wherein the engagement surfaces face each other to a first open position wherein the engagement surfaces are positioned away from each other; an actuation mechanism coupled to the fixation elements (18A, 18B) adapted to move the fixation elements (18A, 18B) between the closed position and the first open position; and a pair of gripping elements (16A, 16B) comprising a first gripping element and a second gripping element, each of the gripping elements (16A, 16B) moveable with respect to one of the fixation elements (18A, 18B) and configured to be moved in opposition to one of the engagement surfaces so as to capture tissue therebetween; a gripper actuator releasably coupled to the implantable fixation device and configured to individually actuate the gripping elements (16A, 16B) comprising a first gripper actuator releasably coupled to the implantable fixation device and configured to actuate the first gripping element, the first gripper actuator having a first configuration and a second configuration, wherein actuating the first gripper actuator between the first configuration and the second configuration moves the first gripping element with respect to the first fixation element, a second gripper actuator releasably coupled to the implantable fixation device and configured to actuate the second gripping element, the second gripper actuator having a first configuration and a second configuration, wherein actuating the second gripper actuator between the first configuration and the second configuration moves the second gripping element with respect to the second fixation element; an elongate delivery shaft having a proximal portion and a distal portion, wherein the distal portion is releasably coupled to the proximal portion of the implantable fixation device, wherein the first gripper actuator and the second gripper actuator are actuatable between the first configuration and the second configuration independently of each other, said system being characterized in that the or each gripper actuator (90, 90A, 90B) comprises a gripper line that extends from the proximal end of the delivery shaft and is coupled to each of the first gripping element and the second gripping element at portions of the gripper line between the proximal end of the delivery shaft and releasably coupled to at least one of the proximal end of the implantable fixation device or the distal end of the elongate delivery shaft.