A method of transfascial suturing may include delivering a suture assembly into an abdominal cavity of a patient, passing a suture anchor, from within the abdominal cavity, through a soft tissue repair prosthetic provided in the abdominal cavity and then through the abdominal wall to a location either above or below the skin, and tightening the suture assembly. An instrument for transfascial suturing may include a handle, a shaft extending from the handle, and a drive system for advancing a suture or suture assembly out of the instrument and across the fascia. The instrument may advance a suture anchor and a suture from within the abdominal cavity and across the abdominal wall to present the suture anchor on the opposite side of the fascia. The instrument may be adapted to present the suture anchor either above or below the skin surface for subsequent tightening of the suture assembly.