and the pair of clamping portions which can be opened and closed for holding the living tissue by the pair of clamping surfaces facing provided on at least one of the pair of clip portions, the energy application surface for applying energy to biological tissue, the pair of clamping and energy output portion comprises at least as one surface, a nipping portion retractable, a cutting member for cutting a biological tissue, has a recess on the energy application surface, and movably guides the cutting member in a sandwich portion and guide groove, is adjacent to the inner surface and the same surface of the concave portion of the guide groove, or guide is disposed so as to bury in the groove, when the pair of holding portions are closed, the projecting between a pair of holding surfaces facing by therapeutic treatment instrument and a gap maintaining unit for maintaining a constant distance between the holding surfaces対向する一対の挟持面により生体組織を挟持する開閉可能な一対の挟持部と、一対の挟持部の少なくとも一方に設けられ、エネルギーを生体組織へ印加するエネルギー印加面を、一対の挟持面の少なくとも一方として備えるエネルギー出力部と、挟持部内を進退可能な、生体組織を切断するための切断部材と、エネルギー印加面上に凹部を有し、切断部材を挟持部内で進退可能に案内する案内溝と、案内溝の凹部の内面と同一面に隣接するか、または案内溝内に埋設するように配置されて、一対の挟持部が閉じた際に、対向する一対の挟持面間で突出することによって、挟持面間の一定距離を維持するためのギャップ維持部と、を備えた治療処置具。
