Apparatus for forming a knot, the apparatus having a first pathway for receiving a first element, and a second pathway for receiving a second element, the first pathway having a configuration which corresponds to the path to be followed by the first element and the second pathway having a configuration which corresponds to the path to be followed by the second element, respectively, in order to form a knot a shuttle for moving the second element and a mechanism for moving the shuttle through the second pathway, whereby, when the first element is received in the first pathway and the second element is connected to the shuttle, movement of the shuttle through the second pathway causes the second element to be moved through the second pathway so as to form a knot around the first element.