A medical device includes a surgical needle attached to a mesh suture having anti-roping elements. The suture is constructed of a macroporous mesh wall that facilitates and allows tissue integration subsequent to introduction to the body, thereby preventing suture pull-through and improving biocompatibility. Advantageously, the anti-roping elements serve to maintain the desired construct of the mesh wall when undergoing axial tensile loads by resisting elongation and loss of outer mesh wall macroporosity, while still permitting a flattening of the suture with lateral loading.