Abstract: An access route formation method for a bile duct includes: inserting a treatment tool into a duodenum as a target; deforming a tissue of a duodenal papilla by pressing the treatment tool against the duodenal papilla; observing a deformed tissue; and forming an opening in the bile duct located below the deformed tissue by incising the deformed tissue or puncturing the deformed tissue in a state in which the treatment tool is pressed against the deformed tissue.

Abstract: The treatment tool including: a tube including a lumen extending in a longitudinal axis of the tube; a wire inserted into the lumen and extending along the longitudinal axis of the tube; a first handle connected to a proximal end portion of the wire; a second handle attached to a proximal end portion of the tube. In a first configuration, the first handle is rotatable relative to the second handle about a rotation axis. In a second configuration, the first handle is non-rotatable relative to the second handle when an applied force applied to the first handle in a rotation direction is equal to or less than a predetermined amount. The first handle is rotatable relative to the second handle when the applied force is greater than the predetermined amount.

Abstract: The treatment tool for an endoscope includes a sheath having a lumen into which a guide wire is insertable, a distal end portion in which a distal end opening communicating with the lumen is formed, a proximal end portion in which a proximal end opening communicating with the lumen is formed, and a sheath slit in which a proximal end communicates with the proximal end opening and which is elongated along a longitudinal axis direction toward the distal end portion; and a funnel tube into which the sheath is insertable, the funnel tube including a through-hole formed on a side surface of the funnel tube at a position corresponding to the proximal end opening of the sheath, and a funnel slit elongated in the longitudinal axis direction.

Abstract: In a method of forming an access route to the bile duct, a needle is introduced into a duodenum, and the introduced needle is pierced into an oral side projection of a duodenal papilla, which is located at an oral position than an opening of the duodenal papilla. The tip of the pierced needle is made to reach the inside of the bile duct to form a tunnel communicating the duodenum and the bile duct, and a treatment device is inserted into the formed tunnel.

Abstract: An endoscopic treatment tool, includes an elongated member having a distal end and a proximal end; a braid disposed between the distal end and the proximal end of the elongated member; a distal indicator disposed on the elongated member between a distal end and a proximal end of the braid, the distal indicator extending along a longitudinal axis of the elongated member; a proximal indicator disposed between the distal end and the proximal end of the braid on the elongated member at a more proximal side of the elongated member than the distal indicator, the proximal indicator extending along the longitudinal axis; and a pre-curved shape portion formed in a curved shape, wherein each of the distal indicator and the proximal indicator has a width less than half of an outer circumferential surface of the elongated member in a circumferential direction of the elongated member, respectively.

Abstract: An endoscopic treatment tool, includes an elongated member having a distal end and a proximal end; a braid disposed between the distal end and the proximal end of the elongated member; a distal indicator disposed on the elongated member between a distal end and a proximal end of the braid, the distal indicator extending along a longitudinal axis of the elongated member; a proximal indicator disposed between the distal end and the proximal end of the braid on the elongated member at a more proximal side of the elongated member than the distal indicator, the proximal indicator extending along the longitudinal axis; and a pre-curved shape portion formed in a curved shape, wherein each of the distal indicator and the proximal indicator has a width less than half of an outer circumferential surface of the elongated member in a circumferential direction of the elongated member, respectively.

Abstract: The disclosed technology is directed to a treatment instrument that comprises a sheath main body having opposed respective distal and proximal end regions. The sheath main body includes an outer diameter such that the sheath main body capable of being fit into the channel for insertion of the treatment instrument of the endoscope. The sheath main body includes a lumen extending along a longitudinal axis in the distal end region. A wire-shaped incising portion is configured to engage with the sheath main body so as to protrude from an outer circumferential surface of the sheath main body in the distal end region and extending along the longitudinal axis of the sheath main body. The wire-shaped incising portion is used to incise a tissue. A wire is attached to at least a portion of the sheath main body and having a region in which the wire has different bending resistances.

Abstract: An access device used with an endoscope includes an access pipe configured to be inserted into a sheath of the endoscope, a piercer disposed on a distal end portion of the access pipe and configured to pierce into a hollow organ through a digestive tract of a patient, and a treatment tool configured to be inserted into the access pipe and to be introduced into the hollow organ by the piercer. The access device is switchable between a first configuration and a second configuration. In the first configuration, a piercing function of the piercer is switched on, so that the piercer pierces the digestive tract and the hollow organ to enter into an interior of the hollow organ, and in the second configuration, the piercing function of the piercer is switched off, the piercer is kept connected to the interior of the hollow organ.

Abstract: In a method of forming an access route to the bile duct, a needle is introduced into a duodenum, and the introduced needle is pierced into an oral side projection of a duodenal papilla, which is located at an oral position than an opening of the duodenal papilla. The tip of the pierced needle is made to reach the inside of the bile duct to form a tunnel communicating the duodenum and the bile duct, and a treatment device is inserted into the formed tunnel.

Abstract: A guidewire holding device comprises a sheath including a lumen, a holder disposed at a distal end of the sheath and configured to be switchable between holding a guidewire and releasing the guidewire, a treatment tool inserted in the lumen to perform an intended treatment, and a wire connected to the treatment tool and configured to move the treatment tool between a first configuration and a second configuration. In the first configuration, the treatment tool is contained insider the lumen, and, in the second configuration, the treatment tool is protruded from the distal end of the sheath.

Abstract: A guide wire holder includes a sheath having a lumen, an operation wire which is inserted through the lumen to be able to advance and retract, and a hook which is continuous with a distal end of the operation wire and protrudes from a distal end of the sheath, wherein the sheath has an inner wall surface which forms a groove configured to extend from the distal end of the sheath to a proximal end side of the sheath, the groove has an opening portion which opens to an outer peripheral surface of the sheath, the hook has a guide wire engagement surface which is engageable with a guide wire, and the guide wire is able to be held between the guide wire engagement surface and the inner wall surface.

Abstract: The disclosed technology is directed to a treatment instrument that comprises a sheath main body having opposed respective distal and proximal end regions. The sheath main body includes an outer diameter such that the sheath main body capable of being fit into the channel for insertion of the treatment instrument of the endoscope. The sheath main body includes a lumen extending along a longitudinal axis in the distal end region. A wire-shaped incising portion is configured to engage with the sheath main body so as to protrude from an outer circumferential surface of the sheath main body in the distal end region and extending along the longitudinal axis of the sheath main body. The wire-shaped incising portion is used to incise a tissue. A wire is attached to at least a portion of the sheath main body and having a region in which the wire has different bending resistances.

Abstract: A treatment instrument for an endoscope used in combination with an endoscope having a raising base at a distal end section of a channel, the treatment instrument for the endoscope includes a sheath section having flexibility; a treatment section installed closer to a distal end side than the sheath section; and a manipulation unit installed at a proximal end of the sheath section and configured to manipulate the treatment section, wherein the sheath section has a sheath main body; a sandwiched portion formed at a distal end side of the sheath main body and sandwiched between the raising base and an inner circumferential surface of the channel; and a torque transmission member configured to transmit a rotational torque input at the proximal end side by a user and turn the sheath main body about the axis.

Abstract: A treatment tool includes a second sheath (12) having a slit (12e) through which a guide wire is configured to be taken in and out of a first lumen, and a sheath-retaining part having a guide wire insertion opening (20b) having a slit (20c) and a main opening (20d), wherein a first end portion of the second sheath (12) has a first side cut surface (12g) and a second side cut surface (12h) intersecting in an X-shape, an axially cut surface formed by cutting in parallel to a central axis (O12) from an end surface (12k), an opening surrounded by the first side cut surface (12g), the second side cut surface (12h), and the axially cut surface and communicating with the first lumen at a position overlapping the main opening (20d), and a piece-like part.

Abstract: An endoscopic treatment tool, includes an elongated member having a distal end and a proximal end; a braid disposed between the distal end and the proximal end of the elongated member; a distal indicator disposed on the elongated member between a distal end and a proximal end of the braid, the distal indicator extending along a longitudinal axis of the elongated member; a proximal indicator disposed between the distal end and the proximal end of the braid on the elongated member at a more proximal side of the elongated member than the distal indicator, the proximal indicator extending along the longitudinal axis; and a pre-curved shape portion formed in a curved shape, wherein each of the distal indicator and the proximal indicator has a width less than half of an outer circumferential surface of the elongated member in a circumferential direction of the elongated member, respectively.

Abstract: A treatment tool includes a second sheath (12) having a slit (12e) through which a guide wire is configured to be taken in and out of a first lumen, and a sheath-retaining part having a guide wire insertion opening (20b) having a slit (20c) and a main opening (20d), wherein a first end portion of the second sheath (12) has a first side cut surface (12g) and a second side cut surface (12h) intersecting in an X-shape, an axially cut surface formed by cutting in parallel to a central axis (O12) from an end surface (12k), an opening surrounded by the first side cut surface (12g), the second side cut surface (12h), and the axially cut surface and communicating with the first lumen at a position overlapping the main opening (20d), and a piece-like part.

Abstract: A medical instrument for an endoscope according to the invention is the medical instrument to be used in the endoscope by being inserted therein, and the medical instrument includes: a flexible elongated sheath having a first lumen and a second lumen; a conductive wire which is inserted into the first lumen and of which a portion of a distal side is exposed to the outside of the sheath as an instrument unit; and a balloon which is attached to the sheath and is expandable with the supply of fluid from the second lumen. The balloon is configured such that an axial dimension thereof is larger than a radial dimension upon expansion and a distal end of the balloon upon expansion is located closer to a proximal side than the treatment unit exposed from the sheath.

Abstract: A stent indwelling device includes a guide catheter and a pusher catheter. The guide catheter includes: a core section; an outer layer section surrounding an outer circumference of the core section; a stent protection section disposed between the core section and the outer layer section, being longer than a dimension of a tube stent, having stiffness resisting compression inward in a radial direction perpendicular to a longitudinal axis of the guide catheter, and having flexibility in a direction in which the guide catheter is curved; and a stopper configured to allow expansion of the stent protection section in a direction along the longitudinal axis and restrict movement of the stent protection section in the direction with respect to the core section.

Abstract: This stent delivery system includes: a guide catheter inserted into the inside of a cylindrical stent, and inserted into the interior of the living body with the stent; a pusher catheter inserted into the interior of the living body with the guide catheter in a state where the guide catheter is inserted into the inside of the push catheter, and which is for pushing the stent along the guide catheter; a stent connecting member for connecting the stent with the pusher catheter; and a stent releasing member for releasing the stent from the pusher catheter by separating the connection between the stent and the pusher catheter depending on the stent connecting member, which is independently operable separately from the guide catheter, and which is inserted into the inside of the pusher catheter.