Abstract: An atrial-appendage ligation treatment tool including: a shaft provided with a lumen having, at a distal end thereof, an opening having an opening diameter that allows passage of a thread of a ligation loop formed in a ring shape, which can be tightened, by connecting an end of the thread at an intermediate position by means of a knot and that does not allow passage of the knot; and a cutting part that is provided at a distal end of the shaft and that cuts, at an inner side of the opening and in the vicinity of the opening, the thread passing through the lumen.

Abstract: An optical fiber scanner includes: an elongated optical fiber; driving piezoelectric elements that are provided on an outer circumferential surface of the optical fiber and produce bending oscillation at a distal-end portion of the optical fiber as a result of an alternating voltage being applied thereto; detecting piezoelectric elements provided on the outer circumferential surface at the distal-end portion of the optical fiber; and a control unit that controls an alternating voltage to be applied to the driving piezoelectric elements on the basis of the voltages produced by the detecting piezoelectric elements.

Abstract: This optical fiber scanner has an elongated optical fiber, a vibration transmission member which has a column-like shape and has a penetrating hole through which the optical fiber penetrates, and a piezoelectric element provided on an outer surface of the vibration transmission member, wherein the penetrating hole is a fitted hole which is formed from a proximal end of the vibration transmission member to a middle of the vibration transmission member and the optical fiber is fitted, and the penetrating hole is an accommodation hole which is formed from the middle to a distal end of the vibration transmission member, which has a large inner diameter than an outer diameter of the optical fiber, and which accommodates a distal end portion of the optical fiber with a gap between the optical fiber and the accommodation hole.

Abstract: Completion of atrial-appendage ligation using a ligation loop is confirmed easily and more reliably. Provided is an atrial-appendage ligation treatment tool including: an insertion portion that is introduced into a cardiac sac through a sheath penetrated through a pericardium; a securing part that secures a distal end of the insertion portion to an atrial appendage; and a sensor that is provided at the distal end of the insertion portion and that detects the state of the atrial appendage.

Abstract: Even if atrial-appendage tissue is damaged due to an excessive force unintentionally exerted during ligation of the atrial appendage, the effect of the damage is minimized. Provided is an atrial-appendage ligation treatment tool that is used, together with an atrial-appendage ligation tool having a ligation part, to perform atrial-appendage ligation treatment. The atrial-appendage ligation treatment tool includes: a compressing portion that is introduced, separately from the ligation part, to a cardiac sac through a sheath penetrated through a pericardium and that compresses the atrial appendage from outside to occlude an internal space therein; and a shaft that is disposed in the sheath in an inserted manner and that supports, at a distal end thereof, the compressing portion.

Abstract: An atrial appendage ligation surgical tool that includes: a tubular loop shaft having an inner hole that penetrates therethrough in a longitudinal direction; and a ligature loop that is in an inserted state in the inner hole of the loop shaft and formed of a wire that forms a loop closed with a knot at a distal end of the loop shaft, the loop being contractible in size by being pulled from a proximal end of the loop shaft. The ligature loop is given a tendency to form a flat ring-shaped loop having a size an atrial appendage is insertable when in a free state, and the knot is placed near an end of the loop in a long axis direction thereof.

Abstract: An atrial-appendage ligation surgical tool that includes a pressing part and a shaft, in which the pressing part is guided into a pericardium via a sheath penetrating through a pericardial membrane, and includes contact portions that press the vicinity of a base of an atrial appendage and have a circular cross-sectional shape and round distal ends, and in which the shaft is in an inserted state in the sheath, supports the pressing part at a distal end, and has a rigidity that enables transmission of a pressing force acting in the longitudinal direction, applied from the proximal end side of the sheath.

Abstract: Provided is a guide sheath that is prevented from coming out of a body cavity so as to allow for stable operation. A tubular guide sheath that guides an insertion section of a medical device to be inserted into a body cavity includes a base-end opening that is provided at a base end of the guide sheath and into which the insertion section is inserted; a distal-end opening that is provided at a distal end of the guide sheath; a flexible bent section that is provided at the distal end of the guide sheath and is elastically bent; and an exit opening that is provided in an outer side surface of the bent section and from which the insertion section extends out.

Abstract: Disclosed is an operation method of an endoscope, the method comprising: a sheath insertion step of percutaneously inserting at least one sheath in a pericardial cavity of a heart; an insertion step of inserting a rigid scope in the sheath; a view field securing step for securing the view field for a surgical site within the pericardial cavity; a guide step for guiding the rigid scope to the surgical site; and an observation step of observing the surgical site with the rigid scope.

Abstract: Provided is an endoscope including an inserted portion that has, sequentially from a distal-end side, a distal-end portion, a bending portion, and a flexible portion; a wire that has an exposed portion that is disposed outside the distal-end portion of the flexible portion along the longitudinal direction and whose positions, at a first position and a second position that is separated from the first position on the base-end side, are restrained with respect to the distal-end portion of the flexible portion in a radial direction; and a wire adjusting portion that changes the length between the first position and the second position of the wire.

Abstract: Provided is an endoscope including an inserted portion that is inserted into a body, an observation optical system that is provided at a distal-end portion of the inserted portion and that acquires an image of the heart, and a supporting expansion portion that makes the heart support the distal-end portion of the inserted portion and that is provided with a basal-end-portion balloon, which is provided closer to a base-end portion than the distal-end portion of the inserted portion is, and a distal-end-portion balloon, which is provided so as to overhang forward from the distal-end portion of the inserted portion, wherein the base-end-portion balloon is disposed on the opposite side from the distal-end-portion balloon, with the inserted portion interposed therebetween.

Abstract: A medical device is provided. The medical device includes a puncture needle that is inserted into body tissue from outside a body and pierces membranous tissue near pulsating tissue inside the body tissue; a tubular protection member that is disposed on the outer side of the puncture needle; a pulse-information acquisition portion that acquires pulse information of the pulsating tissue; and a driving unit that moves the puncture needle and the protection member relative to each other in synchronization with the pulse information of the pulsating tissue acquired by the pulse-information acquisition portion, in such a manner that a tip of the puncture needle is retracted toward a proximal end from a distal end of the protection member when the pulsating tissue expands and that the tip of the puncture needle is projected farther forward from the distal end of the protection member when the pulsating tissue contracts.

Abstract: An endoscope and a surgical instrument are easily manipulated to desired positions and orientations independently while the state of treatment with the surgical instrument can be easily observed using an endoscopic image.

Abstract: With an endoscope including a long, thin inserted portion that is inserted into the body of a patient, securing means for securing the inserted portion to tissue inside the body, the securing means being provided at least at a distal-end portion of the inserted portion, an observation optical system that is provided at the inserted portion and that acquires an image of the tissue, and observation-distance adjusting means for adjusting the distance between the observation optical system and a surface of the tissue, it is possible to attain a stable field of view without having to stop the pulsation or the like of the heart or other tissue.

Abstract: In a pericardioscopic procedure, without providing an endoscope or surgical instrument with special space ensuring means and without unnecessarily dilating the pericardial space, a space necessary for operation of the endoscope or surgical instrument is ensured, so that maneuverability is improved while suppressing complications. Provided is a space ensuring device comprising: a pericardium pressing part for pressing a pericardium from the pericardial space side; a heart pressing part for pressing the surface of a heart from the pericardial space side; and an interconnecting part interconnecting the pericardium pressing part and the heart pressing part, wherein the interconnecting part generates the resilient force enabling expansion against a pressure applied by a pericardium and a heart so as to ensure a space between the pericardium pressing part and the heart pressing part.

Abstract: It is an object to provide an endoscopic heart surgery method with which it is possible to observe an endoscopic image with a stable field of view in the pericardial space. Provided is an endoscopic heart surgery method including an inserting step of inserting an inserted portion of an endoscope into a body from the subxiphoid area and inserting the inserted portion into the pericardial space by penetrating the pericardium in the vicinity of the heart apex; a moving step of advancing the inserted portion toward the base of the heart so that the inserted portion passes through the roof of the pericardial space and is moved toward the heart apex to a treated area in the pericardial space; and an observing step of observing the treated area with the endoscope.

Abstract: An endoscope reduces a diameter of an insertion portion, and cleanses an observation optical system with a guide wire being inserted. The endoscope includes: an elongated insertion portion to be inserted into a body cavity; an observation optical system at a distal end of the insertion portion to collect light from a subject; a channel portion formed in a longitudinal direction of the insertion portion, through which a fluid is passed and a guide wire is inserted; a seal portion in the channel portion to seal a gap between the channel portion and the guide wire where the guide wire is inserted through the channel portion; and an opening portion on a proximal end side of the seal portion to discharge a fluid flowing through the channel portion toward the observation optical system.

Abstract: Provided is a guide sheath that is prevented from coming out of a body cavity so as to allow for stable operation. A tubular guide sheath that guides an insertion section of a medical device to be inserted into a body cavity includes a base-end opening that is provided at a base end of the guide sheath and into which the insertion section is inserted; a distal-end opening that is provided at a distal end of the guide sheath; a flexible bent section that is provided at the distal end of the guide sheath and is elastically bent; and an exit opening that is provided in an outer side surface of the bent section and from which the insertion section extends out.

Abstract: Disclosed is an operation method of an endoscope, the method comprising: a sheath insertion step of percutaneously inserting at least one sheath in a pericardial cavity of a heart; an insertion step of inserting a rigid scope in the sheath; a view field securing step for securing the view field for a surgical site within the pericardial cavity; a guide step for guiding the rigid scope to the surgical site; and an observation step of observing the surgical site with the rigid scope.

Abstract: An endoscope and a surgical instrument are easily manipulated to desired positions and orientations independently while the state of treatment with the surgical instrument can be easily observed using an endoscopic image.