A suture retention device includes a stack of suture engaging members which can be provided by coils or other segments of a spring. A suture engages with the stack so as to permit travel of the retention device along the suture in one direction more facilely than travel along the suture in the other direction. The retention device can include a housing that encloses the spring or other stack structure, and the suture can pass from a first hole in the housing, through the suture engaging members, and to a second hole in the housing. A suture anchor can be attached to the suture, and the resulting assembly can be combined with a needle designed to introduce the anchor and suture into patient tissue, e.g. in the conduct of a gastropexy procedure.