Abstract: A surgical system for performing gastrointestinal procedures is disclosed. The system includes an elongated body defining an endoscope lumen. The body is adapted to be inserted into the esophagus with a proximal end extending from a body orifice. A working member includes at least one side disposed suction cavity and a cutting device configured to excise a surface layer from the tissue that is captured in the suction cavity. One or more needles are also provided in the working portion, which can be used to apply suture to the captured tissue and/or to inject fluid into the captured tissue prior to excision. Particular applications may be to treat Barrett's esophagus, to treat GERD, or for performing gastroplasty in the stomach.

Abstract: A device and method for selectively engaging or penetrating a layer of a luminal organ wall where the luminal organ wall has a plurality of layers including an outermost layer and an innermost layer adjacent to the lumen of the organ. The device and method select one of the plurality of layers of the organ wall other than the innermost layer and deploy from within the lumen of the organ a tissue device through the innermost layer to a specific depth to engage or penetrate the selected one of the plurality of layers. The device and method may be employed to create luminal pouches or restrictive outlets. In a stomach organ, the device and methods may be employed to treat obesity by forming a gastric pouch with or without a restrictive outlet.

Abstract: A surgical instrument for surgically joining a tissue is disclosed. The surgical instrument comprises a handle assembly, an elongate portion extending distally from the handle assembly, a pair of opposed jaw members, and a tissue stop. The tissue stop is mechanically engaged with a first jaw member and is configured to retain the tissue between jaw members. The tissue stop is movable between a first position, where a stopping portion of the tissue stop is disposed between a tissue-contacting surface of the first jaw member and a tissue-contacting surface of the second jaw member, and a second position, where the stopping portion is between the tissue-contacting surface of the first jaw member and a lower surface of the first jaw member. A portion of the tissue stop is made of stamped metal section and a portion of the tissue stop is made of an overmolded plastic section.

Abstract: A surgical instrument for holding a suturing needle comprises an operating section, an insert section having an insert-section distal end extension at a distal end of an insert section body, a clamping portion, a rotatable holder portion, a receiving member having a first contact surface, and a transmitting member having a second contact surface. The insert section body has an inner bore along a first axis in a longitudinal direction. The insert-section distal end extension has a rotation-allowing groove on an inner peripheral surface of an inner bore provided along a second axis at a predetermined angle with respect to the first axis. The rotatable holder portion is allowed to be passively rotatable about the second axis under an external force applied to the suturing needle when a gap is formed between the transmitting member and the receiving member.

Abstract: A device for tensioning barbed sutures used for securing tissue or prosthetic devices includes a handle, and a shaft having a proximal end connected with the handle and a distal end remote therefrom. The distal end of the shaft includes a pressure applying surface for pressing against the tissue and the prosthetic devices. The tensioning device includes a pair of grooves extending through the shaft from the pressure applying surface at the distal end of the shaft toward the proximal end of the shaft. A barbed suture is tensioned by aligning a first section of the suture in the first groove and a second section of the suture in the second groove. After the first and second suture sections are aligned in the grooves, the proximal ends of the sections may be pulled for applying tension to the suture.

Abstract: A surgical instrument may be used to apply tension to a flexible suture to close and secure a broken or cut bone (e.g. a sternum following a sternotomy). The device preferably applies an adjustable tension to the flexible suture in order to secure the bone together. Multiple instruments may be used together to ensure the desired tension is applied to the entire bone structure being secured with the flexible sutures. Once the desired tension is achieved, the device preferably provides a mechanism to apply a uniform twist to the flexible suture to lock the flexible suture in place. The instrument preferably decreases the upward tension applied to the flexible sutures over the duration of the application of twisting. The device may automatically cut the flexible suture, or the flexible suture may be cut by the surgeon once the twisting action has been performed.

Abstract: A method of repairing soft tissue of a joint of a human extremity, such as a hand or foot. The method includes maintaining a metapodial bone intact; inserting a suture passing instrument into a space adjacent the metapodial and phalangeal bones; passing the suture through a volar ligament near a distal end of the metapodial bone and reattaching the volar ligament to the proximal phalanx. The method also includes making an incision on the dorsal aspect of the extremity to expose the dorsal aspect; inserting the distal portion of the suture passer instrument through the incision on the dorsal aspect of the extremity; inserting the distal portion of the suture passing instrument into a tendon sheath connected to a volar plate; and passing a portion of a suture through the volar plate.

Abstract: An apparatus includes an elongate member, an actuator, and a thread member. A portion of the elongate member defines a central axis. The elongate member defines a slot which extends along an axis parallel to the central axis. The actuator is coupled to the elongate member and is accessible through the slot. The actuator is moveable from a first position to a second position different than the first position. The thread member is coupled to the actuator and has a receiving portion. The thread member is moveable from a first position to a second position different than the first position when the actuator is moved from its first position to its second position.

Abstract: A suture needle guard and method of operation for temporarily holding a suture needle during a surgical operation. The suture needle guard includes a hollow tube having a closed first end and an opposite, funnel shaped second end. The hollow tube has a hollow bore that extends from a closed bottom end to a funnel opening in the funnel shaped second end, and is configured to temporarily retain the suture needle within the suture needle guard. The suture needle guard also includes an immobilizing structure for temporarily immobilizing the suture needle guard during the surgical operation.

Abstract: A pre-sutured anchor including a deformable anchor sleeve with a lumen sized to receive the therapy delivery element. An outer surface of the anchor sleeve including one or more annular compression grooves oriented generally co-axial to the lumen. At least one compression member is located in a compression groove in an open configuration. The compression member includes at least one stop. A suture material pre-tied in a self-locking compression knot extends around each compression member. The suture material includes distal ends adapted to receive a tension force that is transmitted as a radial compression force to deform the compression members and substantially engage the stop in a compressed configuration. The anchor sleeve compressively engages the therapy delivery element in the compressed configuration.

Abstract: The present invention relates to a tissue securement system, device and method for endoscopy or endosonography-guided transluminal interventions whereby a litigation or anchor is placed and secured into soft tissue. An objective of this invention is to provide a method to reduce gastroesophageal reflux by endosonography-guided intervention. Specifically, endosonography is used to insert a litigation element through the esophageal wall, through the diaphragmatic crus and into the fundus of the stomach. This litigation element placed from the esophagus and around the angle of His that may create a barrier to gastroesophageal reflux.

Abstract: A suture tool for fixing the gastric wall to the abdominal wall includes a first puncture needle for insertion, a suture thread, a second puncture needle for removing the suture thread, a linear grasping member and one or more anchor member. The tip end portion of the suture thread is inserted into the first puncture needle and a hook of the linear grasping member is inserted into the second puncture needle for removing the suture thread inserted into the first puncture needle for securing the gastric wall to the abdominal wall.

Abstract: An apparatus includes a carrier configured to be movably disposed within a channel defined by an elongate member. The carrier includes a proximal end portion and a distal end portion. The proximal end portion is configured to be coupled to an actuator. The distal end portion includes a protrusion and an engagement surface. The protrusion has a tip configured to bodily pierce tissue. The protrusion is configured to be received within a lumen defined by a connecting portion of an implant, such as, for example, a pelvic floor implant, such that the tip extends through the lumen defined by the connecting portion of the implant. The engagement surface is configured to engage a portion of the connecting portion of the implant to limit movement of the connecting portion of the implant relative to the protrusion.

Abstract: An apparatus for anulus fibrosus repair includes a shaft, a pair of curved suturing needles mounted in parallel on the shaft, and a rotational driving mechanism connected to the shaft, which is configured to rotate the shaft and the pair of needles about a rotation axis of the shaft. Each needle includes a substantially semi-annular body having a proximal end, a distal end, an inner periphery, and an outer periphery, and an arm extending radially inward from the proximal end, in which a concavity is formed in the body proximate to the distal end extending in a direction away from it. Also disclosed is a suturing technique associated with use of the repair apparatus.

Abstract: A surgical device configured for cooperation with a trocar to allow for delivery of suture to effect a closure of a wound is described.

Abstract: A method for manipulating a suture is provided. The method includes providing support to tissue using a snare of a suture manipulation device and ensnaring, using the snare and without moving the snare, a portion of the suture when the portion of the suture passes through the tissue and is released by a needle. The method further includes securing, while removing the support to the tissue, the portion of the suture with the snare. The method further still includes removing the snare with the portion of the suture from the tissue.

Abstract: The present disclosure concerns embodiments and methods of use of an introducer that is adapted to facilitate insertion of a prosthetic device, such as a prosthetic heart valve, into a patient's vasculature. In one embodiment, the introducer comprises an elongated body defining a central lumen extending between distal and proximal ends of the body. The introducer body can also have a longitudinally extending gap extending along the length of the body between the distal end proximal ends. The gap in the introducer allows a user to place the introducer around implant sutures by passing the sutures through the gap and into the central lumen. Similarly, the gap allows the introducer to be easily removed from the sutures and/or a delivery device by passing them outwardly through the gap.

Abstract: Methods and devices for treating female stress urinary incontinence are disclosed. The methods include transvaginally accessing the pelvic cavity and introducing a suburethral sling into the retropubic space. In some embodiments the ends of the sling are attached to an anatomical support structure. In other embodiments, the ends of the suburethral sling are not attached to an anatomical support structure. The devices include a surgical instrument for blunt dissection of the pelvic cavity which includes a curved shaft and a blunt distal end. A hook deployment device may optionally be attached to the surgical instrument.

Abstract: A suturing assembly is provided that is configured to pull a capsule attached to a suture through tissue. The suturing assembly includes a shaft aligned on a longitudinal axis of the suturing assembly, and a head coupled to the shaft. The head includes a proximal portion and a distal end spaced apart from the proximal portion by a throat. The proximal portion houses a needle that is movable through a needle exit port. The proximal portion of the head and the needle exit port are both aligned on the longitudinal axis. A proximal side of the distal end of the head defines a cavity adapted to receive the capsule and a distal side of the distal end of the head defines a slot adapted to allow the suture to pass through the distal end of the head and into the cavity.

Abstract: Methods and devices for repairing a cardiac valve. A minimally invasive procedure includes creating an access in the apex region of the heart through which one or more instruments may be inserted. The device can implant artificial heart valve chordae tendineae into cardiac valve leaflet tissues to restore proper leaflet function and prevent reperfusion. The device punctures the apex of the heart and travels through the ventricle. The tip of the device rests on the defective valve and punctures the valve leaflet. A suture or a suture/guide wire combination is inserted, securing the top of the leaflet to the apex of the heart. A resilient element or shock absorber mechanism adjacent to the outside of the apex of the heart minimizes the linear travel of the device in response to the beating of the heart or opening/closing of the valve.

Abstract: A gripper is capable of efficient gripping in a narrow space. A gripper has a first arm and a second arm which can open and close about a supporting pin and are configured so that opposing surfaces formed by opening and closing the first and second arms form the holding portion. The gripper is characterized in that a pair of clipping members is connected with the holding portion of the first arm and the second arm so that the pair of clipping members can rotate about support points relative to the holding portion, and in that a rotation manipulation portion is connected with the clipping members at a position offset from the support points and applies a displacement to the position to which the rotation manipulation portion is connected.

Abstract: An apparatus includes a flexible fixation member having a body with a longitudinal extent and a width, the body defining a plurality of openings through the body, each of the plurality of openings formed substantially cross wise through the width of the body, and a suture having two terminal ends, the suture being interwoven through each of the plurality of openings in the body of the fixation member such that multiple portions of the fixation member are slidably coupled to the suture and configurable to form a cluster within a surgical site.

Abstract: A flexible member securing assembly to secure a flexible member relative to tissue is provided and includes a shaft, an arm, an anchor, and a flexible member grasper. The shaft extends along a longitudinal axis from a first end and a second end. The arm is extendable from the shaft second end and the flexible member grasper is adjacent to a distal end of the arm to position the flexible member in relation to the anchor. The anchor is removably positioned at the shaft second end and can retain the flexible member in the tissue. Methods of securing a flexible member are also provided.

Abstract: A device for helping a surgeon to fold the correct amount of tissue when conducting a gastric plication procedure is described. The guide device includes an elongated flexible guide, a securing device positioned on the distal end of the guide, and means for guiding stomach tissue during a gastric plication procedure that are positioned longitudinally along the distal end of the guide and proximal to the securing device. The means for guiding stomach tissue include the use of a shaping balloon to serve as a guide for final stomach volume and/or a groove on the guide device to regulate formation of the tissue fold. Methods for using the guide device to carry out gastric plication procedures are also described.

Abstract: A suture tensioning device includes a first portion including a first inner surface having a first surface and a first beveled surface and another first portion including another first inner surface having another first surface and another first beveled surface. The first surface of the first inner surface and the another first surface of the another first inner surface contact. The first portion and the another first portion are connected to define a first handle. A first cleat is defined between the first beveled surface and the another first beveled surface.

Abstract: A suture construction and method for forming a suture construction is disclosed. The construction utilizes a suture having an enlarged central body portion defining a longitudinal passage. First and second ends of the suture are passed through first and second apertures associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes constriction of the longitudinal passage, thus preventing relative motions of the captured portions of the suture.

Abstract: An automated needle deployment device is provided. In one embodiment, the automated needle deployment device comprises a pusher, a needle, a tube, and an actuator. The pusher has a needle engaging end. The needle has a sharp end and an opposite end. A suture is associated with the needle. The pusher and needle are slidably disposed within the tube. The actuator comprises a control and a spring and is operatively associated with the pusher. Actuation of the actuator moves the pusher towards the needle expulsion end of the tube such that the needle engaging end of the pusher engages the needle and expels the needle from the tube.

Abstract: A vascular closure delivery system is provided comprising a needle and suture delivery unit and a suture knot system. The delivery unit may comprise a tube, a leg, a tensioning device, a pusher, a needle, and an actuator, the tube being configured to house the needle. In an open position, the tensioning device exerts tension on the leg, and the pusher and suturing apparatus are in a delivery configuration for delivering the needle to the internal tissue wall. Further, actuation of the actuator moves the pusher towards an expulsion end of the tube such that the pusher engages the needle and expels the needle from the tube. The suture knot system comprises a shaft, an inner tubular member, and an inner rod. The inner tubular member is radially translatable with respect to the shaft. The inner rod is slidably coupled to and is axially translatable within the inner tubular member.

Abstract: An arthroscopic suture cutting device according to embodiments of the invention includes an outer tube; an inner rod including an outer surface and an aperture, a distalmost edge of a second distal opening located distally of a distalmost edge of a first distal opening, the inner rod can receive a suture extending through both distal openings; in a loading position, the inner rod extends distally of the outer tube to receive the suture; in an intermediate position, the distal openings are closer to the outer tube, such that the suture is permitted to slide through the aperture without release; and in a cut position, the distalmost edges of the distal openings are within the outer tube. Moving from intermediate position to cut position draws the suture between outer tube and inner rod, urging the inner rod radially toward the second distal opening, cutting the suture between the outer tube and the distalmost edge of the second distal opening.

Abstract: A device having one or more adjustable loops or coils associated with an implant body for use in soft tissue reconstructions is provided. One exemplary embodiment of a device includes a body and a suture filament, with the filament being used to form a self-locking sliding knot disposed on a top side of the body and a plurality of adjustable coils that are substantially disposed on the body's bottom side. Terminal ends of the filament located above the body's top side can be passed through an opening of a Lark's Head knot from opposite sides, thus forming a self-locking sliding knot, and then the terminal ends can be tensioned to adjust a circumference of the coils. Changing a coil's circumference changes a location of a ligament graft disposed on the coil. Other configurations of devices and systems, as well as methods for performing ACL repairs, are also provided.

Abstract: In repairing soft tissue with a bone anchoring instrument (such as reattaching a tendon of a torn rotator cuff), the bone anchoring instrument may be used to anchor the soft tissue to a region of bone. The anchors inserted into the underlying bone may have one or more lengths of suture or wire attached thereto which may be tensioned independently of one another to affix the soft tissue to the bone by having a selector mechanism selectively engage and disengage ratcheted tensioning wheels from one another. Suture loading mechanisms may be employed for passing suture lengths into and/or through the anchors prior to deployment into the bone where such mechanisms may employ suture snares which are configured to reconfigure from an expanded shape through which suture lengths may be easily passed to a low-profile shape which secures the suture lengths within the snare.

Abstract: A suture passer device may include a first jaw, a second jaw, and a tissue penetrator which may penetrate through tissue positioned between the first and second jaws to carry a suture. Further, the device may include an actuator which may manipulate at least one of the first or second jaws and the tissue penetrator Additionally, the first and second jaws may be substantially parallel to one another at any position to which the at least one jaw is manipulated. Additionally, the tissue penetrator may travel along an arcuate path from a first position, recessed within the first jaw, to a second position where the tissue penetrator extends through the tissue to be positioned in communication with the second jaw.

Abstract: An adjustable anchor system for securing tissue to bone, including an anchor having at least one passage extending from a proximal end toward a distal end. The passage defines a restriction such as a restricted opening. The anchor has at least one bone-engaging feature disposed between the proximal and distal ends. The system further includes a first material formed as a closed loop and capable of being placed through a portion of the tissue, and a second filament having a terminal end, a post limb and a sliding knot tied between the terminal end and the post limb to establish an elongated, adjustable-length loop which extends beyond the proximal end of the anchor and captures the closed loop of the first material. The knot of the second filament is restrained by the restricted opening when tension is applied as desired to the post limb to shorten the elongated loop to draw the tissue toward the anchor.

Abstract: A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose with first and second noose limbs connected, preferably slidably, to the filament engagement feature. The first and second noose limbs emerge from the anchor as first and second free filament limbs that are capable of being passed through tissue to be repaired and then passable through the noose. The noose is capable of receiving the free filament limbs and strangulating them when tension is applied to at least one of the free filament limbs and the noose to enable incremental tensioning of the tissue after anchor fixation. Preferably, the snare assembly further includes a flexible sleeve joining at least some portion of the first and second free filament limbs to facilitate passing of the free filament limbs as a single unit.

Abstract: A device for loading a surgical knotting element on an applicator tool. One embodiment of the device includes a channel dimensioned to receive an applicator tool comprising a coupling. A surgical knotting element comprises a coupling complementary to the coupling of an applicator tool and a suture path. A carriage receives the surgical knotting element. The carriage is moveable in a transverse direction relative the channel between a first position where the knotting element is misaligned with the channel and a second position where the couplings are engaged with one another.

Abstract: A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose with first and second noose limbs connected, preferably slidably, to the filament engagement feature. The first and second noose limbs emerge from the anchor as first and second free filament limbs that are capable of being passed through tissue to be repaired and then passable through the noose. The noose is capable of receiving the free filament limbs and strangulating them when tension is applied to at least one of the free filament limbs and the noose to enable incremental tensioning of the tissue after anchor fixation. Preferably, the snare assembly further includes a flexible sleeve joining at least some portion of the first and second free filament limbs to facilitate passing of the free filament limbs as a single unit.

Abstract: A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose on a first portion of at least a first limb and has a second portion connected to the filament engagement feature of the anchor. Preferably, at least one free filament limb, which in some embodiments is a length of the first filament and in other embodiments is a second filament, is capable of being passed through tissue to be repaired and has at least one end passable through the noose to enable incremental tensioning of the tissue after the anchor is fixated in bone. The noose strangulates the free filament limb when tension is applied to at least one of the free filament limb and the noose.

Abstract: A thread catcher for surgical sewing material consisting of a handle, a hollow shaft positioned on the distal side of the handle, and a catching device that is mounted so that it can be slid lengthwise within the hollow shaft by means of a drive element and whose distal end, which can slide out of the distal end of the hollow shaft, is configured as a catcher loop. To create a thread catcher for surgical sewing material that is simple to operate and ensures rapid and secure grasping of the surgical sewing material, it is proposed with the invention that the catcher loop should consist of at least three segments that are distally connected with one another.

Abstract: Minimally invasive surgery for repairing a disruption in the spinal dura uses a pistol-grip forceps to permit the forceps to be used as a needle driver down a tubular cannula 14-20 mm in diameter and 40-120 mm long. The pistol grip permits one-handed use and provides an unobstructed view of the surgical site down the cannula. Jaws at the forceps' distal end are textured to frictionally engage the needle with sufficient force to enable the surgeon to drive the needle through tissue at the surgical site without damaging the needle. A bayoneted needle holder with a removable needle positioning tip having a unique configuration enables the surgeon to use the other hand to push a needle with an attached suture through the dura, after which the forceps are used to drive the needle and the suture through the edges of the disruption so the suture can be tied off.

Abstract: A system for repairing a meniscus includes a suture including a first anchor, a second anchor, and a flexible portion connecting the first anchor and the second anchor. The flexible portion includes a self-locking slide knot between the first anchor and the second anchor. The system also includes a needle having a longitudinal extending bore and an open end. The bore is configured to receive the first anchor and the second anchor. The system further includes a pusher configured to be movable within the bore of the needle. The pusher is configured to (1) discharge the first anchor and the second anchor, and (2) push the self-locking slide knot after the discharge of the second anchor.

Abstract: A method and apparatus for reattaching the opposed ends of a member, such as a tendon, ligament or bone, during preparing and healing of the member using a surgical repair device that can be securely attached to the member and then safely guided through tortuous anatomy for reattachment and repair. The repair device further includes structural means so as to secure opposed ends of the member against separation during healing. Devices for aiding in the positioning of the surgical repair device are provided.

Abstract: A needle delivery device that has particular application for providing needles for minimally invasive spinal surgical procedures. The device includes an elongated pincher having opposing rails that is slidable within a channel defined in an extended base portion. Widened end portions of the rails hold the needle and push it out of an end of the device where it is released. The pincher is then retracted to a location where the end portions can pick up a next needle to be delivered.

Abstract: A novel catheter-based system which ligates the left atrial appendage (LAA) on the outside of the heart, preferably using a combination of catheters and/or instruments, e.g., a guide catheter positioned inside the left atrial appendage which may assist in locating the left atrial appendage and/or assist in the optimal placement of a ligature on the outside of the appendage, and a ligating catheter and/or instrument outside the heart in the pericardial space to set a ligating element at the neck of the left atrial appendage.

Abstract: Devices, methods, and kits for tensioning tethers during a tissue modification procedure are described. In some variations, a tether coupled to anchors embedded in tissue may be tensioned to provide a cinching effect that tightens or compresses the tissue by bringing two pieces or sections of the tissue together. In certain variations, the tether may then be locked (e.g., to maintain the tension), and/or excess tether may be severed. The devices, methods, and/or kits may be used, for example, in minimally invasive procedures.

Abstract: A soft tissue tensioning system comprises a manual suture tensioning device having a bar and a finger guard which is orthogonal to the bar. A lateral suture cleat is disposed on each lateral end of the bar, and a primary suture cleat extends about a top and a bottom of each of the opposed lateral ends of the bar.

Abstract: An instrument for delivering a suture transfascially may include a handle, a shaft extending from the handle, and a pair of needles that are moveable to an extended position beyond the end of the shaft. One or more sutures are carried by the instrument and may be delivered transfascially. A transfascial suture assembly includes a suture having first and second segments and an intermediate segment therebetween. A force distributing member is locatable at the intermediate segment. Suture retainers may be provided at the end of each suture segment, and may have a connection that is moveable relative to the suture segment. A method of delivering transfascial sutures includes inserting a twin-needle instrument loaded with one or more sutures into an abdominal cavity and deploying, from within the abdominal cavity, the suture carrying needles through a soft tissue repair patch and then through at least part of the abdominal wall.

Abstract: The present invention relates to a tissue securement system, device and method for endoscopy or endosonography-guided transluminal interventions whereby a ligation or anchor is placed and secured into soft tissue. An objective of this invention is to provide a method to reduce gastroesophageal reflux by endosonography-guided intervention. Specifically, endosonography is used to insert a ligation element through the esophageal wall, through the diaphragmatic crus and into the fundus of the stomach. This ligation element placed from the esophagus and around the Angle of His to create a barrier to gastroesophageal reflux.

Abstract: A tissue fastening device includes a suture clip holder and a suture cutter. A suture clip can be releasably secured to the suture clip holder, and a suture line or lines can pass through the clip and adjacent the suture cutter. A first movement of a control handle causes the suture clip to be released from the suture clip holder, and a second movement of the control handle causes the suture cutter to cut the suture line or lines. The first movement is different from the second movement. The first movement can be rotational, with the second movement being longitudinal. Alternatively, the first movement can be longitudinal, with the second movement being rotational. The device may include a main body, an inner body, and an outer body.

Abstract: A ligature device for medical treatment has an operating device that has a ligature tool for medical treatment fitted onto a distal end portion thereof. The operating device is provided with a cutting member that is able to move freely backwards and forwards and is used to cut a ligature wire of the ligature tool for medical treatment. A distal end side of the cutting member has an inclined end portion that is inclined relative to the direction of forward and backward movement, and a blade portion is provided in this inclined end portion.

Abstract: Provided is an anastomosis device including a first head holding a first anastomosis ring, a second head holding a second anastomosis ring, a first guide bar connected to the first head and switching a release position and a standby position to each other, wherein the first guide bar includes a first rotation groove, a second guide bar connected to the second head and switching the release position and the standby position to each other, wherein the second guide bar includes a second rotation groove, and a rotation driver moving approximately in a parallel direction to the first and second guide bars and including a first guide protrusion and a second guide protrusion, which move along the first and second rotation grooves, respectively.