Abstract: To provide a tool for safely and reliably securing a route for endermically approaching the interior of the body; more specifically, an endoscope-equipped puncture balloon that is designed to allow a balloon that does not immediately burst when punctured by a puncturing needle or the like to be used as a target, and that can be used by installing or inserting an endoscope in a tube holding such balloon. In a thin-walled main body tube 1 equipped with an endoscope-installed section at the rear end, a balloon 2 is disposed on the front surface thereof, and a branch tube 4 communicating with the interior of the balloon 2 in a gas-liquid flow manner is disposed on the main body tube 1, the branch tube 4 having a connector 5 annexed to the rear end thereof; thus it is not until the liquid in the balloon is absorbed without the balloon immediately bursting when punctured by a puncturing needle that a bore can be secured until the balloon is contracted.

Abstract: An endoscope testing apparatus including a base, a main rail coupled to the base, a first centering mount coupled to the main rail, an optical test target holder coupled to the main rail, a second centering mount coupled to the optical test holder, the second centering mount being coaxially alignable with the first centering mount, and an optical scanning device coupled to the main rail and coaxially alignable with the first centering mount and the second centering mount. The test target holder includes an optical test target having a selectively adjustable distance between the optical test target and the second centering mount and a selectively adjustable angle formed between an axis formed by the centering mounts and the test target.

Abstract: Axial visualization systems which utilize axially aligned imaging instruments for visualizing through an imaging hood purged of blood via a transparent fluid are described where an imaging element extending from a support shaft may be aligned within a working lumen defined through a deployment catheter. The imaging element may be positioned distal to the hood in its collapsed state and within the hood in its expanded state. The imaging element may be configured to seat itself securely within the catheter or to angle itself to adjust the viewing angle. Additionally, a disposable visualization sheath having a transparent lens may also be utilized to house an imaging instrument therein.

Abstract: The protective sheath front end of the disclosed curved section protective sheath for covering the curved section of an endoscope covers the outer periphery of the front end of the endoscope. A filamentous member is wound around the outer periphery of the protective sheath front end, affixing the protective sheath front end to the front end of the endoscope. An adhesive agent is layered on the outer periphery of the protective sheath front end so as to cover the filamentous member. A ring member is fitted to the protective sheath front end so as to cover the adhesive agent. The inner surface of the ring member is bonded to the filamentous member with the adhesive agent therebetween.

Abstract: An endoscopic attachment apparatus for coupling an endoscope with an endoscopic instrument includes an attachment ring having a ring body with first and second apertures respectively shaped and dimensioned for the receipt of an endoscope and an endoscopic instrument. The attachment ring includes an annular body defining the first aperture and the annular body is provided with an endoscope release mechanism for facilitating release of the endoscope from the attachment ring.

Abstract: Methods and devices are provided for providing suction and/or irrigation to locations within a body cavity. In general, the methods and devices can allow instruments within a body cavity to be cleaned during a surgical procedure without having to remove the instruments from the body cavity. In one embodiment, an end effector is provided that includes an elongate body having a cleaning base formed thereon. The end effector can be configured as a modular element configured to be removably and replaceably attachable to a distal end of an elongate shaft. The cleaning base can have one or more ports formed through a surface thereof. The cleaning base can be configured to provide suction and/or irrigation through the one or more ports to clean a face of a surgical instrument seated in the cleaning base or in close proximity to the cleaning base.

Abstract: A dissection device comprising an elongate cannula having proximal and distal ends and a central axis and arranged to receive at least a remote viewing device therein, a handle arranged to be attached to the proximal end of the elongate cannula and a dissection tip arranged to be attached to the distal end of the elongate cannula, the dissection tip comprising a curved hollow shroud that when the dissection tip is orientated for use defines a substantially concave working cavity having an open underside, the hollow shroud comprising a pair of laterally extending lateral extensions, each wing extending from an opposing lateral portion of the periphery of the hollow shroud.

Abstract: The present application relates to a medical gripping device (1) with a flexible shaft (2) with a front end (13) and a rear end (14) and a web (5) comprising at least one web element, wherein the web (4) is attached to the front end (3) of the shaft (2). The medical gripping device additionally has at least two branches (5, 6) which are hinged on the web (4), and at least two at least partly flexible control mechanisms (7, 151, 155, 8, 152, 156) which are at least partly arranged in the shaft (2), wherein each individual branch (5, 6) can be moved individually with respect to the web (4) by means of its individual control mechanism (7, 151, 155, 8, 152, 156). Furthermore, the medical gripping device has a grip (150) at the rear end (14) of the flexible shaft (2), by mans of which grip the medical gripping device (1) can be held and actuated.

Abstract: An endoscopic incision system includes: an endoscope; a cylindrical member for covering at least a distal end of an insertion section of the endoscope; and at least an incision section for incising a living tissue, the incision section being provided to a distal end of the cylindrical member and being capable of being exposed from the distal end of the cylindrical member outwardly. In this configuration, the radially expanding incision section will not be twisted or bent, and the incision section prevented from inadvertent fall-off can maintain the desirable shape when it is operated and rotated.

Abstract: A bead for stitching, a vacuum cap for suction-holding an internal organ, and an apparatus for stitching an internal organ using the vacuum cap are disclosed. The bead includes a through hole which is formed vertically through the bead so that a stitching fiber passes through the bead. At least one of both ends of the bead is inclined relative to a transverse direction of the bead. The bead is shaped to pass through a hole formed in a stitching needle. That apparatus includes an endoscope tube having a stitching needle which is movable in a longitudinal direction thereof and a suction tube for drawing air, and a vacuum cap having at an end thereof a fastening hole to which the endoscope tube is fastened. A suction hole is formed in the vacuum cap in a direction crossing the fastening hole.

Abstract: A system is provided for advancing medical devices along an endoscope to a selected target anatomy in a patient. The advancing system includes a tether having a first portion disposed through a working channel of an endoscope and a second portion disposed external the endoscope. The advancing system may include a guiding device configured to advance a medical device beyond a distal portion of the endoscope to a selected target anatomy.

Abstract: An endoscopic support device configured to support an endoscope during a surgical procedure is disclosed. The endoscopic support device has a connection ring with a height smaller than its diameter and configured to be in an open or deployed position and in a closed or non-deployed position. The support device also has at least two guiding elements, an orientation component, and extension means for manipulating the ring between the deployed and non-deployed positions.

Abstract: A surgical device for use with an endoscope. The device includes an end cap removably affixable to a distal end of the endoscope such that at least a portion of the end cap distally extends beyond the distal end of the endoscope. The end cap defines a through bore for receiving the distal end of the endoscope, and the end cap includes an outer surface defining first and second tracks substantially perpendicular to a longitudinal axis of the through bore. The device further includes a first working channel having a distal end disposed in the first track and movable along a length of the first track between a first position and a second position. The device further includes a second working channel having a distal end disposed in the second track and movable along a length of the second track between a first position and a second position.

Abstract: A harness for a medical device is provided which can suppress defective products from being passed to the subsequent process. The harness 10 for medical device 1 comprises: cables 20A-20D which is to be inserted into a tube 3 of the medical device 1; a camera 30 which is connected to one ends of the cables 20A-20D; and printed wiring boards 40A and 40B which is connected to the other ends of the cables 20A-20D, and a following Expression (1) is satisfied. W1<D1??(1) In the above Expression (1), W1 denotes the width of the printed wiring boards 40A and 40B, and D1 denotes the inner diameter of the tube 3.

Abstract: A marker to be attached to an endoscopic treatment tool for precisely directing a tip of the treatment tool to a target site with no additional physical burden to the patient is provided. A marker 1 used in an endoscopic treatment tool to be inserted in a guide sheath, the marker including: a body 2; and a tip section 4A for removably fixing the body 2 to a middle section of the endoscopic treatment tool, wherein the distance between the body 2 and a tip of the endoscopic treatment tool can be determined freely.

Abstract: A visual inspection device includes a body having a support portion and a grip portion extending from the support portion. The device also includes a flexible cable having a first end portion coupled to the body and a second end portion, and a camera assembly coupled to the second end portion of the flexible cable. The camera assembly includes an image sensor operable to transmit image data through the flexible cable. The device further includes a display supported by the support portion of the body. The display is electrically connected to the flexible cable to display image date from the image sensor. The device is powered by a rechargeable battery pack removably coupled to the body.

Abstract: Provided is an endoscope with a handle and an endoscope shaft connected to the handle, which has a bendable section and a rigid section, adjoining it, with a support extending in the longitudinal direction of the endoscope shaft, wherein the bendable section has a flexible outer tube the end of which facing the rigid section rests on the support, wherein a fixing sleeve is connected to the end section and covers the end of the outer tube facing the rigid section such that said end is clamped for fixing between the fixing sleeve and the support.

Abstract: An endoscope procedure instrument provided with: a tube part that is cylindrical in shape and attaches to the front end of the endoscope, the tube part having a slit provided to the side surface thereof extending along the direction of the central axis; and a grasping member that is disposed to the tube part extending along the slit, for holding a biologic tissue with respect to the endoscope.

Abstract: An endoscope hood includes: an opening portion which is placed on a far side with respect to a leading end surface of an insertion part of an endoscope, wherein an opening is formed on the opening portion in a direction substantially orthogonal to an axial direction of the insertion part; and a flexible hood part configured to cover a portion other than the opening, on the far side with respect to the leading end surface of the insertion part, wherein gas inside of the hood part is sucked from a gas suction port of the insertion part, the opening is adsorbed onto a region to be measured, and the hood part is deformed so as to be closely adhered to the region to be measured within a range of the opening and a probe, to thereby fix the probe to the region to be measured in a state where the probe is set therealong.

Abstract: A working unit of a manipulator includes a hollow joint shaft, wires disposed as power transmitting members in the hollow joint shaft, and a distal-end working unit mounted on an end of the hollow joint shaft and movable by the wires. The wires are wound around respective tubular members in the distal-end working unit. The hollow joint shaft has a pair of visual checking holes defined in respective side walls thereof near the distal end thereof for allowing the wires to be visually checked therethrough. The visual checking holes are positioned to expose the tubular members therethrough.

Abstract: The present invention provides methods and apparatus for obtaining endoluminal access. An elongate body is configured for insertion within a body lumen, conduit, organ, orifice, passageway or cavity, the elongate body having a working axis and a distal region, and an articulating element disposed near the distal region, the articulating element configured to articulate off-axis from the working axis of the elongate body. The elongate may achieve access in an endoluminal or a laparoscopic fashion. Methods of using the apparatus are also provided.

Abstract: A propellable apparatus comprises one or more rotatable membranes. The rotatable membranes include an inner surface at least partially defining an encircled region and a continuous outer surface that turns outward to engage a cavity or lumen wall, for example, and turns inward to at least partially encompass a central region defining a longitudinal path. The membranes are powerable to provide movement relative to the cavity or lumen wall. The apparatus further comprises an inflatable and deflatable support structure, configured to bias the outer surface of the membranes outward to engage the cavity or lumen wall at a first outer diameter, and be deformable inward in response to a compressive force or operator command to provide a second outer diameter that is less than the first outer diameter. In some examples, the rotatable membranes include belt-like membranes, and the inflatable and deflatable support structure includes at least one impermeable bladder.

Abstract: A video endoscope system includes a reusable control cabinet and an endoscope that is connectable thereto. The endoscope may be used with a single patient and then disposed. The endoscope includes an illumination mechanism, an image sensor, and an elongate shaft having one or more lumens located therein. An articulation joint at the distal end of the endoscope allows the distal end to be oriented by the actuators in the control cabinet or actuators in a control handle of the endoscope. Fluidics, electrical, navigation, image, display and data entry controls are integrated into the system along with other accessories.

Abstract: An endoscope insertion assembly for performing endoscopy, including an endoscope insertion tube operative for passage through a body cavity, and an optical assembly operative for inspection of the body cavity, the optical assembly being selectably insertable within the endoscope insertion tube.

Abstract: Devices and methods are provided for manipulating scoping devices, surgical tools, and/or tissue. An exemplary system for manipulating a scoping device can include a scoping device having a working channel, a tether extending through the working channel, and an internal coupling member attached to the tether and positioned adjacent to a distal end of the scoping device. The internal coupling member can be magnetically coupled to an external coupling member. An exemplary method for manipulating a scoping device can include inserting at least a portion of a scoping device into a body cavity and positioning an external coupling member proximate to an external surface of tissue such that the external coupling member magnetically couples through the tissue to an internal coupling member disposed within the body cavity and attached to a tether passed through at least one working channel of the scoping device.

Abstract: The present invention provides methods and apparatus for obtaining endoluminal access. An elongate body is configured for insertion within a body lumen, conduit, organ, orifice or passageway, the elongate body having a working axis and a distal region, and an articulating element disposed near the distal region, the articulating element configured to articulate off-axis from the working axis of the elongate body. Methods of using apparatus of the present invention are also provided.

Abstract: An improved ligating system with a ligating barrel having an adjustable diameter for use with endoscopes of varying sizes is disclosed. The adjustable diameter may be provided by a collet, a flexible helical band, a plurality of screws, or a tapered elastomeric section.

Abstract: An endoscopic assembly for an endoscope is disclosed. The assembly comprises a ligator barrel having proximal and distal portions. The proximal portion has a seat and a receiving wall extending to a proximal end. The receiving wall has a first threaded portion formed thereon. The assembly further comprises a connector for connecting the ligator barrel about the endoscope. The connector has a scope portion and a tip portion. The scope portion has a receiving end through which the endoscope is disposed to engage the seat for connecting the ligator barrel about the endoscope. The tip portion has a second threaded portion formed thereon and are configured to cooperate with the first threaded portion to receive the receiving wall and attach the connector with the ligator barrel. The first and second threaded portions are configured to cooperate with each other to tighten the connection of the ligator barrel about the endoscope as the threads increase surface area contact therebetween.

Abstract: A needleless fluid delivery system for delivering therapeutic fluids to treatment sites within a patient. The fluid delivery system can include an automated injector source and a needleless access device. The access device can include a delivery scope and a treatment specific applicator. The automated injector source, delivery scope and applicator can be operably coupled with quick-connect style fittings so as to allow for quick replacement and maintenance of used or damaged components. The automated injector source can include a hands-free input mechanism allowing a medical professional to use both hands in manipulating the delivery scope and needleless applicator at the same time an injection is desired. The delivery scope and needleless applicator can comprise flexible or rigid lengths of tubing based on the accessibility of the treatment site. The needleless delivery system can include an imaging system for precisely position the applicator with respect to the treatment location.

Abstract: An endoscope treatment system includes: an endoscope; and a treatment tool that has a sheath that is inserted in a channel of an insertion portion of the endoscope, in which projection portions that project outward from the sheath in the radial direction are provided, and engagement portions that engage the projection portions are provided near the channel of the endoscope.

Abstract: A hood attachment jig includes a holding member whose diameter is increasable and that holds an endoscope hood in a state where the holding member is inserted into the endoscope hood; a diameter increasing member that increases the diameter of the holding member by entering the holding member, so that the diameter of the endoscope hood increases; and a push-out member that, when an attachment operation is performed in a state where a tip portion of the endoscope enters the holding member with the increased diameter, pushes out the holding member and the endoscope to separate the holding member and the endoscope from the diameter increasing member so that the endoscope hood, a force of restitution of which reduces the diameter of the holding member, is brought into contact with an outer circumferential surface of the tip portion of the endoscope and further pushes out the endoscope to detach the endoscope from the holding member so that the endoscope hood is attached to the endoscope tip portion.

Abstract: The invention relates to a tube assembly for an endoscope comprising a disposable tube that surrounds a working channel and preferably also a flushing channel and fixing means for fixing the disposable tube to the endoscope. Said fixing means have a fixing unit which is used to fix the disposable tube on the distal end of the endoscope in a rotationally and axially fixed manner. The endoscope fixing means also have a guide device which is used to displaceably fix the disposable tube on respective sections of the endoscope that are at a distance from the distal end of said endoscope.

Abstract: The present invention is an endoscope system comprising an endoscope provided with a distal end inserted into a subject body and a proximal end having a site capable of being held by a physician and provided with an endoscope insertion unit having a first flexible portion arranged on the distal end thereof and a second flexible portion coupled to the proximal end of the first flexible portion and provided with a site having an outer diameter larger than a site having the maximum outer diameter of the first flexible portion; and an endoscope insertion assisting device, in which the inner diameter of a distal opening of an insertion hole through which the endoscope insertion unit is inserted is substantially equal to the outer diameter of the second flexible portion.

Abstract: An instrument for cleaning a lens of a scope includes an elongated sheath and a cleaning portion. The elongated sheath defines a lumen dimensioned and configured to slidingly receive the scope therein. The cleaning portion is positioned in a distal portion of the lumen. The cleaning portion includes a membrane formed from an elastic material. The membrane includes one or more openings to facilitate translation of the scope through the membrane.

Abstract: An endoscopic lens cleaning apparatus includes an end cap, a lens, first and second magnets, one or more guide rails to couple housings for the first and second magnets, and a wiper assembly that is attached to and capable of gliding along the guide rail. The wiper assembly houses a wiper magnet that interacts with the first and second magnets. At least one of the wiper magnet or first and second magnets is an electromagnet, coupled to a power supply via a switch. A controller alternates the polarity of current supplied to the electromagnet to cause the wiper assembly to glide along the rail. A wiper attached to the wiper assembly likewise glides along the lens, thereby cleaning it. The controller is programmable, and can operate in continuous, intermittent, or as needed cleaning modes.

Abstract: A system for minimizing leakage of fluid distending media by the sides of the endoscopic instrument in endoscopic procedures such as arthroscopy, hysteroscopy or laparoscopy. A double-wall flexible tubular sheath having walls containing pressurized fluid is mounted over an endoscopic instrument. The double-wall flexible tubular sheath moves in and out of a natural opening of a tissue cavity or through an incision made in the cavity wall.

Abstract: An endoscope with a flexible endoscope shaft has an endoscope head arranged at its distal end. The endoscope head is a sleeve, open at both end faces. Functional units, such as an optical system, a working channel, an illumination and a cooling system for the illumination are accommodated in the endoscope head. The cooling system has a heat exchanger integrally formed with the sleeve in the latter which forms a closed cooling chamber for generating a coolant flow. The illumination, which is in the form of an external conductor plate supporting an illumination means, is arranged adjacent to the distal end wall of the heat exchanger, to discharge thermal energy via the end wall of the heat exchanger to the coolant flow. The external conductor plate is mechanically supported on, or has only a minimum distance from, the heat exchanger end wall.

Abstract: Embodiments of the invention include a medical device for accessing a patient's body portion and used for diagnosis and treatment of medical conditions. Embodiments of the invention may include a particular endoscopic positioning mechanism for placing an endoscope and an additional treatment device within desired body portions in order to assist in diagnosis and treatment of anatomical diseases and disorders. In particular, a medical device according to an embodiment of the invention includes a positioning mechanism configured to maintain the relative position of a treatment instrument with respect to an underlying endoscope during a treatment procedure.

Abstract: An electric bending operation device can be mounted to an insertion portion of a medical instrument for observation including an electric bending portion. The electric bending operation device may include: an insertion portion mounting mechanism; a rotation mechanism; an insertion portion operation section; and a support column.

Abstract: The invention relates to test equipment for rigid endoscopes, but also for flexible endoscopes and video endoscopes. The equipment includes an enclosure having a cover hingedly coupled to a base, an optical test target coupled to the cover, an endoscope support stand pivotably coupled to the enclosure and a bed contained within the base including a plurality of indentations shaped for receiving individual pieces of endoscope testing equipment. The testing equipment can include magnification loupes, light post adapters, battery powered light sources, cleansing tissues and a ruler. A support bracket is coupled between the cover and the endoscope support stand wherein the endoscope support stand is pivotably coupled to the support bracket.

Abstract: A cap for attachment to a distal end of an endoscope and a method of positioning the cap on the endoscope are provided. The cap includes a tubular body having a proximal portion, a distal portion and a lumen extending therethrough. The proximal portion includes a first portion and a second portion where at least one of the first portion and the second portion includes a connector for operably connecting the first portion and the second portion. The cap has in open configuration wherein at least a portion of the first portion and the second portion are spaced apart and movable relative to each other. The cap also has a closed configuration wherein the first and second portions are connected and the lumen if formed therethrough. The cap in the closed configuration is sized and shaped to be positionable on the distal end of the endoscope.

Abstract: Medical systems, devices and methods are disclosed for suturing a perforation in tissue, that may be employed endoscopically and/or laparoscopically, and that offer simple, reliable and controllable placement of suture around a perforation for complete closure thereof. One embodiment of the medical device generally includes an endcap for use with an endoscope to suture an opening in tissue using a tissue anchor. The endcap has a tubular shape defined by an annular sidewall, and the sidewall defines an interior space. A side port is further defined by the annular sidewall and is in communication with the interior space. The side port is sized to receive and locate the tissue within the interior space for suturing. A support rib is positioned within the interior space and distal to the side port. The support rib and sidewall define a piercing aperture therebetween that supports the tissue being sutured.

Abstract: An endoscope system has an endoscope; an attachment for the endoscope, having a non-circular irregularly shaped hole that communicates with an opening of a channel of the endoscope and attached to a forward end of an insertion section of the endoscope; and a treatment instrument for the endoscope, having a flexible tube and a treatment section. An extension/retraction section having a non-circular cross section corresponding to the shape of an opening of the irregularly shaped holes is provided at a forward end of the flexible tube, and the irregularly shaped hole restricts rotation of the flexible tube. Further, the treatment section has directivity about its axis relative to the flexible tube and its rotation is restricted.

Abstract: A plurality of concepts related to HIFU therapy are disclosed, including a technique to spatially track and display the relative positions of a HIFU focal point and an imaging plane from an ultrasound imager, so that a clinician can ensure that the HIFU focus remains in the image plane during HIFU therapy, thereby facilitating image guided HIFU therapy. Also disclosed are a plurality of transvaginal probes that include a HIFU transducer optimized for the treatment of uterine fibroids. In one embodiment, the probe includes a piezoceramic crystal bonded to an aluminum lens, to achieve a HIFU transducer having a focal length of about 4 cm. In another embodiment, the probe includes a generally spoon-shaped transducer including a plurality of individual emitter elements. Still another concept disclosed herein is a method for evaluating a quality of a coupling between a liquid-filled volume encompassing a HIFU transducer and a tissue interface.

Abstract: An outer tube for natural orifice surgery. The outer tube can have interchangeable inserts to establish a desired size and number of lumens. A distal tapered soft plastic plug may be provided to cover the distal end of the tube. Different segments of the tube may have different stiffness characteristics.

Abstract: Various embodiments of a surgical device and methods of using the surgical device are disclosed. The surgical device may comprise a collar configured to fit over a distal face of an endoscope and rotate about a longitudinal axis of the endoscope. The surgical device may also comprise a flexible, elongate translating mechanism coupled to the collar and extending proximally from the collar. Applying a linear force to the translating mechanism may cause the translating mechanism to exert a rotational force on the collar. In addition, the surgical device may comprise a hollow cap coupled to a distal end of the collar. The cap may be pivotable relative to the collar in a plane parallel to the axis. In addition, the cap may have a first open end configured to face the endoscope and a second open end configured to face distally.

Abstract: A signal transmission device includes a transmission unit, a first connection unit, a second connection unit, and a reception unit. The transmission unit sends a transmission signal. The first connection unit includes a first electrode electrically connected to the transmission unit. The second connection unit includes a second electrode that engages with the first connection unit, and, when engaged with the first connection unit, is statically coupled with the first electrode. The reception unit is electrically connected to the second electrode and receives the transmission signal.

Abstract: A flexible interlocking structure for a handheld endoscope includes a flexible rod having an interlocking unit connected to its one end. The interlocking unit includes front, middle and rear joints each having a hollow portion. Each joint is formed with at least two guiding holes, locking tabs and locking notches. The engagement between the locking tabs and the locking notches of the adjacent joints constitutes the interlocking unit. Both ends of the flexible rod are connected to a handle portion and an inspection module respectively. A transmission cable and driving wires are disposed through the hollow portions and the guiding holes in such a manner that they are located between the inspection module and the handle portion. By operating a steering device of the handle portion, the driving wires pulls the front joints to cause the interlocking unit to bend accordingly, thereby controlling the rotation of the inspection module.

Abstract: An endoscope includes an insertion portion, a resin tubular covering member, a fastening member and a contact surface. The insertion portion includes a bending portion. The resin tubular covering member is covering a covering target part in the insertion portion including the bending portion. The fastening member is wound around the outer periphery of at least one end of the covering member and fastens the end to the covering target part. The contact surface is provided on the side of the covering target part covered with the end, is placed in contact with the end face of the covering member and becomes thinner toward the side of the covering member.

Abstract: The endoscope treatment tool 1 has a distal end member 3 which is installed in an endoscope. A connection member 4 is attached to the distal end member 3 in a freely rotatable manner. In the connection member 4, a portion which is supported by a cap 12 of the distal end member 3 is a second pivot shaft 15. A portion penetrating a supporting member 21 of a treatment portion 5 is a first pivot shaft 23. The first pivot shaft 23 is also a rotational axis of a pair of forceps members 22 provided in the treatment member 5. When the forceps members 22 are used, a coil sheath 6 is extended by an operation at the side of the proximal end. The connection member 4 rotates about the second pivot shaft 15, which is a fulcrum, and the treatment portion 5 moves forward beyond the cap 12. In accordance with the present invention, it is possible to resolve the difficulty of procedures by positioning the treatment portion in an appropriate location.