Though he does possess a "zanpakutō", named , he tends to misplace it as he rarely needs to use it. When it strikes an opponent, Hisagomaru heals their wounds rather than causing them damage. A red gauge on the blade then fills depending on the severity of the healed wounds. Once the gauge is filled and it is released with the command , Hisagomaru transforms into a scalpel and changes its name to . In this state, Hisagomaru unleashes a reiatsu-based attack (similar to kido or cero) equal to the severity and number of wounds that have been healed. The proportion of its strength, if enough energy is stored, is nearly strong enough to decapitate a Menos. However, upon releasing the energies, Akiero Hisagomaru retains its scalpel form, rendering it effectively useless in hand-to-hand combat. He can also release the current amount of energy before it is filled, although this is only mentioned and not actually seen. It is also the only known Zanpakutō that has different names in sealed form and shikai.