Abstract: A surgical instrument is described for tying together the two free ends of a suture placed into the tissue of a surgical patient. The surgical device comprises a handle having an actuator, an elongated shaft attached to the handle, a cartridge, and a pusher. The cartridge removeably attaches to the shaft and comprises a cable with two free cable ends with suture connectors attached thereto. The cable has a plurality of pre-tied loops disposed proximally to the two free cable ends. The pusher is slideably disposed on the shaft and transfers the pre-tied loops from the cable to the two free suture ends of the suture filament. In a preferred embodiment, the pusher comprises a lug train and a driver. The lug train has a plurality of lugs flexibly attached to each other and slideably attached to the distal end of the shaft. When the cartridge is attached to the distal end of the shaft, each of the pre-tied loops is positioned operationally over a corresponding lug.