An instrument for delivering a transfascial suture, comprising: an actuation handle to actuate the instrument; an elongated shaft (406, 1104) extending from the handle and including a distal end; a first drive member (308,414,1112) and a second drive member (308,414,1112) that are operatively coupled to the actuation handle, the first and second drive members being moveable to an extended position beyond the distal end of the shaft (406,1104) in response to actuation of the instrument and to a retracted position within the shaft (406,1104), a suture carried by the instrument, the suture defined by a first segment (452,1122) and a second segment (452,1122), and including a force distributing member between the first and second segments (452,1122), and first and second suture retainers (450,500) configured to be carried by the first and second drive members (308,414,1112), respectively, as the first and second drive members (308,414,1112) move to an extended position, the suture being arranged in the instrument so that the first and second suture segments (452,1122) are coupled to the first and second suture retainers (450,500) respectively, and carried by the suture retainers (450,500) as the drive members (308,414,1112) move to the extended position, the suture retainers (450,500) being releasable from the drive members (308, 414,1112), wherein each of the first and second drive members (308, 414, 1112) is solid, and the first and second suture retainers (450,500) are configured to be carried on an external portion of the first and second drive members (308,414,1112), respectively, and wherein each of the first and second drive members, or each of the first and second suture retainers, have a sharp end adapted to pierce abdominal wall tissue. an actuation handle to actuate the instrument; an elongated shaft (406, 1104) extending from the handle and including a distal end; a first drive member (308,414,1112) and a second drive member (308,414,1112) that are operatively coupled to the actuation handle, the first and second drive members being moveable to an extended position beyond the distal end of the shaft (406,1104) in response to actuation of the instrument and to a retracted position within the shaft (406,1104), a suture carried by the instrument, the suture defined by a first segment (452,1122) and a second segment (452,1122), and including a force distributing member between the first and second segments (452,1122), and first and second suture retainers (450,500) configured to be carried by the first and second drive members (308,414,1112), respectively, as the first and second drive members (308,414,1112) move to an extended position, the suture being arranged in the instrument so that the first and second suture segments (452,1122) are coupled to the first and second suture retainers (450,500) respectively, and carried by the suture retainers (450,500) as the drive members (308,414,1112) move to the extended position, the suture retainers (450,500) being releasable from the drive members (308, 414,1112), wherein each of the first and second drive members (308, 414, 1112) is solid, and the first and second suture retainers (450,500) are configured to be carried on an external portion of the first and second drive members (308,414,1112), respectively, and wherein each of the first and second drive members, or each of the first and second suture retainers, have a sharp end adapted to pierce abdominal wall tissue.