Embodiments of invention are directed to micro-scale of mesoscale tissue approximation instruments that may be delivered to the body of a patient during minimally invasive or other surgical procedures. In one group of embodiments, the instrument has an elongated (longitudinal) configuration while with two sets of expandable wings that each have a toggle configuration that can be made to expand when located on opposite sides of a distal tissue region and a proximal tissue region and can then be made to move toward one another to bring the two tissue regions into more a proximal position. In some embodiments, multiple tissue approximation instruments are located within a delivery system for sequential delivery to a patient's body.