Abstract: A laser light irradiation system that irradiates a stone in a body with laser light to cause the stone to be dust, the laser light irradiation system including a laser fiber that emits the laser light, and a processor configured to control a frequency of the laser light emitted from the laser fiber, wherein the processor is configured to switch between first laser light of a first frequency and second laser light of a second frequency such that the second laser light is emitted at least before or after an emission timing of the first laser light, the first laser light generating a water flow that pulls the stone toward the laser fiber, the second laser light generating a water flow that stirs the stone.

Abstract: A medical manipulator including: a multi-lumen tube that includes an elongated flexible portion having flexibility and a bendable bending portion disposed at a distal end of the flexible portion; a distal-end portion disposed at a distal end of the bending portion; a proximal-end portion disposed at a proximal end of the flexible portion; the flexible portion and the bending portion include a plurality of lumens configured to accept a plurality of bending wires, respectively. The plurality of second lumens passing through the flexible portion are formed in spiral shapes about a longitudinal axis of the flexible portion, and the plurality of second lumens passing through the bending portion are formed extending linearly and parallel to a longitudinal axis of the bending portion.

Abstract: A cannulation method includes inserting an endoscope close to the papilla, deforming the papilla or the bile pancreatic duct, and inserting an insertion device into the bile pancreatic duct. The papilla may be manipulated to move the opening portion of the bile pancreatic duct to a position visible through the endoscope, and the insertion device may be inserted into the opening portion.

Abstract: An endoscope reprocessor includes a processing tank configured to accommodate an endoscope placed therein, a liquid containing portion configured to store a liquid, a conduit configured to supply the liquid in the liquid containing portion into the processing tank, a pump disposed in the conduit, a flowmeter disposed in the conduit, and processing circuitry. The processing circuitry is configured to output, to the pump, a signal for supplying the liquid into the conduit, obtain a value of the flowmeter, set a predetermined threshold based on the value of the flowmeter, and detect a shortage of the liquid in the liquid containing portion when the value of the flowmeter is less than the predetermined threshold.

Abstract: An endoscope bending operation mechanism comprises an up-down bending operation knob (a left-right bending operation knob), an up-down bending pulley (a left-right bending pulley) supported for rotation by a pulley case, the up-down bending pulley is configured to move by an operation force from the up-down bending operation knob, an up-down bending operation wire (a left-right bending operation wire) having a proximal end and a distal end, the proximal end of which is connected to the up-down bending pulley (the left-right bending pulley) and the distal end of which is connected to a bending portion of an insertion section of an endoscope, a stopper member, a protruding portion, the stopper member and the protruding portion are movable relative to each other, an amount of relative rotation between the up-down bending pulley (the left-right bending pulley) and the pulley case is restricted by the protruding portion contacting the stopper member.

Abstract: A reprocessor includes a first tube connectable to a first conduit of medical equipment with a gap therebetween, a second tube connectable to a second conduit of the medical equipment, a supplying apparatus configured to supply a fluid to the first and second conduits via the respective tubes, and a processor. The processor controls the supplying apparatus to start supplying the fluid to the second conduit at a first timing, and to start supplying the fluid to the first conduit at a second timing before the fluid supplied to the second conduit flows out from the gap via a merging point and the first conduit, thereby pushing the fluid back toward the merging point. The medical equipment includes an internal conduit including the first conduit, the second conduit, and a third conduit, which are open at one end and merge with each other at the merging point at another end.

Abstract: A cannulation method includes inserting an endoscope into a duodenum, bringing a distal end section of the endoscope to a position where a duodenal papilla is within a field of view of the endoscope, promoting secretion of pancreatic juice or bile by administering a drainage stimulant, determining an amount of relaxation of the duodenal papilla, and performing cannulation into a biliary duct through the duodenal papilla where the amount of relaxation is greater than a predetermined amount.

Abstract: A flexible-manipulator guide member is provided in an inserted portion of a flexible manipulator including the elongated flexible inserted portion, the movable portion disposed at the distal end of the inserted portion, a drive portion disposed at the base end of the inserted portion, and the elongated driving-force transmitting member that transmits motive power of the drive portion to the movable portion, and is provided with a lumen through which the driving-force transmitting member passes in the longitudinal direction, wherein the lumen has a twisted shape about the longitudinal axis of the inserted portion.

Abstract: A medical support apparatus includes: a processor configured to acquire a plurality of image files in which a plurality of images of an inside body of a subject captured at multiple imaging magnifications, imaging magnification information, and imaging times are associated, based on the imaging magnification information, set an image having a first imaging magnification among the plurality of images to a first image, set an image having a next first imaging magnification on in time series among the plurality of images to a second image, and determine images captured in a period from an imaging time of the first image to an imaging time of the second image as third images, group, based on a result of the determination result, the third images into an image group, select a representative image of the image group, and display the representative image on a display.

Abstract: An endoscope processor includes a connection interface and processing circuitry. The processing circuitry is configured to receive, via the connection interface, an image signal to generate an object image, normalize, by a blue pixel value, a sum of a red pixel value and a green pixel value of at least one pixel of the object image, thereby calculating an index of the at least one pixel, identify, based on the index, which of a plurality of symptom levels defined using a plurality of thresholds the at least one pixel falls into, acquire an identification color corresponding to the identified symptom level, and generate an identification image using the identification color of the at least one pixel.

Abstract: PROBLEM TO BE SOLVED: To simply and surely obtain a movement-adjustable optical system, which keeps strength against the pressure variation of external environment and is constituted to be airtight for surely preventing entering of high-pressure and high-temperature steam, without necessitating the external force of a magnet, etc. SOLUTION: At least one of members constituting an optical unit can be extended/contracted and constituted of metallic tube-like elastic members 25 and 27. Thus, though relative pressure variation between an optical system constituted to be movable and airtight and external environment occurs at the time of autoclave sterilization, tube-like elastic members 25 and 27 are not provided with steam permeability of themselves and perfectly interrupt high-pressure and high-temperature steam. In addition, there is not a mechanical gap and transmission of high-pressure and high-temperature steam is prevented.

Abstract: A cleaning apparatus management unit manages the utilization status of a first cleaning apparatus that can clean an endoscope that has been manually cleaned in a procedure in which one or more steps are skipped and the utilization status of a second cleaning apparatus that can clean an endoscope that has been manually cleaned by performing all the steps. A reception unit receives step information indicating a completed step during the manual cleaning of the endoscope. When the received step information indicates a predetermined step that comes before a final step, an assignment processing unit determines a cleaning apparatus to be assigned to the endoscope based on the relationship between scheduled completion time of the manual cleaning when the implementation of the one or more steps that come after the predetermined step is skipped and the utilization status of a plurality of cleaning apparatuses managed by the cleaning apparatus management unit.

Abstract: A traction tool for performing traction of a suture thread under a flexible endoscope is provided. The tool includes a shaft, a first holder which is provided at a distal end of the shaft and is configured to hold the suture thread or a suture needle attached to the suture thread, and a second holder which is provided closer to a proximal end side of the shaft than the first holder and to which the suture thread is hooked. The second holder is expandable in a radial direction of the shaft.

Abstract: An accommodating container accommodates a medical instrument. A sensor unit acquires environmental information obtained at the time transportation of the accommodating container. A recording unit records the environmental information acquired by the sensor unit. A control device controls the functions of a medical instrument. The control device restricts the functions of the medical instrument based on the environmental information recorded in the recording unit.

Abstract: An endoscope includes: an insertion portion formed using a first resin material and having a fusion surface, the first resin material having a melting point of a first temperature; a bending portion formed using a second resin material having a melting point of a second temperature higher than the first temperature, the bending portion being interposed in the insertion portion at a predetermined position and being bendable in a predetermined direction; and an elastic member formed into a tubular shape by using a third resin material different from the first resin material, the elastic member being configured to cover the bending portion, an end portion of the elastic member being fused to the fusion surface.

Abstract: An electrode for a high-frequency medical device in which a coating film is formed on at least a part of a surface of a treatment section of the medical device, wherein the coating film includes a silicone resin, and at least one type of filler having conductivity. Particles of the fillers are fusion-bonded to each other to form a conductive path, and/or a particle of the filler and an electrode substrate disposed on a surface of the treatment section are fusion-bonded to form a conductive path.

Abstract: An endoscope processor comprises a processor. The processor causes a light source to generate, as illumination light, light in a first wavelength band in which hemoglobin absorption is smaller than that in a green band and light in a second wavelength band which is different from the first wavelength band. The processor causes an endoscope to image a return light so as to output an image signal. The processor acquires a first image obtained by the light in the first wavelength band from the image signal and detects unevenness information on mucosa from the first image. The processor acquires a second image obtained by the light in the second wavelength band from the image signal and synthesizes the unevenness information with the second image so as to generate a display image in which an uneven region in the second image is emphasized.

Abstract: An ultrasound imaging system includes an ultrasound imaging device configured to transmit and receive a signal based on transmission and reception of an ultrasound wave. The ultrasound imaging device includes a processor including hardware. The processor is configured to: generate a plurality of pieces of data of ultrasound images of an inside of a subject based on the signal, the ultrasound images being spatially separated from one another; invert a magnitude relationship of a luminance value of each of pixels in each of the ultrasound images; automatically set a first boundary across which the luminance value changes by a predetermined amount based on data of one of the ultrasound images; and automatically detect a second boundary in each of the ultrasound images based on the set first boundary.

Abstract: A clip device can include a clip including a pair of clip arms, a capsule including a channel, the channel slidably inserted into a proximal end of each clip arm of the pair of clip arms, and a coupler attached onto the proximal end of the capsule. The coupler includes a pair of deployment arms and a pair of retention arms. The pair of retention arms are configured to engage with a corresponding portion of an applicator. Wherein a first length of the coupler in a first direction is longer than a second length of the coupler in a second direction in a cross-section. The cross-section crosses the pair of retention arms and the pair of deployment arms and is perpendicular to a longitudinal direction of the coupler.

Abstract: An endoscope includes a flexible tube extending along a center axis from one end to another end. The flexible tube includes a tube main body formed of a first composition having a first Young's modulus. The tube main body includes protrusions on an outer circumferential surface thereof and a recess defined by the protrusions. The flexible tube further includes a filling structural portion disposed in the recess and formed of a second composition having a second Young's modulus lower than the first Young's modulus. The protrusions are each surrounded by the recess and isolated from one another. When the recess includes first sections extending in an axial direction parallel to the center axis, the first sections are intermittently formed in the axial direction. When the recess includes second sections extending in a circumferential direction around the center axis, the second sections are intermittently formed in the circumferential direction.

Abstract: An insertion instrument comprises an insertion portion, an operation portion located proximally relative to the insertion portion. The operation portion includes a housing having an exterior body, a light source apparatus located inside the exterior body, a conduit for a fluid. The conduit includes a first portion located outside the exterior body, a second portion located inside the exterior body and in contact with an outer surface of the light source apparatus.

Abstract: An energy treatment apparatus includes: a first power source configured to supply power by which a transducer generates an ultrasonic vibration; a second power source configured to supply a high frequency current and a high frequency voltage to a first grasping piece and a second grasping piece; a first detecting circuit configured to detect an electrical characteristic relating to the power supplied to the transducer over time; a second detecting circuit configured to detect the high frequency current and the high frequency voltage supplied to a portion between the first grasping piece and the second grasping piece over time; and a processor configured to control the first power source and the second power source.

Abstract: A fluid feeding and suction apparatus includes a common conduit including an endoscopic connection end and a second end, a fluid feeding conduit in fluid communication with the common conduit via the branching connector, a fluid suction conduit in fluid communication with the common conduit via the branching connector, a fluid feeding container connected to the fluid feeding conduit, a fluid suction container connected to the fluid suction conduit, a gas feeding conduit connected to the fluid feeding container, a gas suction conduit connected to the fluid suction container, and a pump connected to the gas feeding conduit and the gas suction conduit. The second end connected to a branching connector. The pump is configured to feed a supply gas to the gas feeding conduit and to suction a suction gas from the gas suction conduit.

Abstract: A medical stapler includes a stapling head having a staple ejection portion and having a length in one direction, an anvil openably and closably coupled to the stapling head by a rotation shaft and having a length in one direction, a staple receiving portion provided in the anvil and provided at a position facing the staple ejection portion when the stapling head and the anvil are in a closed state, and a first guide portion configured to be displaced to a protruding orientation or a retracted orientation. In the protruding orientation, the first guide portion is capable of lifting a treatment tool.

Abstract: A biopsy device includes: a hollow needle; a wire located inside the needle and having a helical drill portion; a rotation mechanism moving the drill portion; a sheath covering the needle, the needle and the wire being movable in a longitudinal direction of the needle with respect to the sheath; and an operating unit on a proximal side of the needle, the wire, and the sheath. The unit includes: a main body fixed to a proximal end of the sheath; and a knob fixed to a proximal end of the wire and supported by the main body so as to be movable in the longitudinal direction and rotatable about a longitudinal axis of the wire. The mechanism includes: a threaded portion, on the main body, having a pitch equal to a pitch of the drill portion; and a joint portion, on the knob, joined to the threaded portion.

Abstract: An electrode for an electrosurgical handheld instrument consists of an electrically conductive wire, the two ends of the wire being connectable to an electrode carrier of the handheld instrument. In this case, the wire has two portions R1 and L1, which are adjacent to the two ends of the wire and are aligned parallel to one another and rectilinearly. Two second portions R2 and L2 follow on from these two first portions R1 and L1, these two portions R2 and L2 being connected to one another by a portion C. This portion C in turn has a flattened portion CC.

Abstract: An endoscope includes an insertion section extending along a longitudinal axis and including a distal end portion, the distal end portion includes a distal end structural member including a conduit integrally formed as a through hole with the distal end structural member, the conduit configured so that a fluid flows through the conduit, the conduit includes a nozzle and a supply conduit located proximally relative to the nozzle, wherein a cross-sectional area of the supply conduit is greater than a cross-sectional area of the nozzle.

Abstract: A relay adapter includes a first connector configured to connect to a processor supplying a first power. The relay adapter includes a second connector configured to connect to an insertion instrument operable using a second power. The relay adapter includes a power circuit coupled to the first connector to receive the first power. The power circuit is configured to convert the first power into the second power The power circuit is coupled to the second connector for delivering the second power to the second connector. The relay adapter includes a switching circuit coupled to the power circuit. When the second connector is not connected to the insertion instrument, the switching circuit prevents the power circuit from delivering the second power to the second connector.

Abstract: A learning data generating system includes a processor. The processor inputs a first image to a first neural network to generate a first feature map by the first neural network and inputs a second image to the first neural network to generate a second feature map by the first neural network. The processor generates a combined feature map by replacing a part of the first feature map with a part of the second feature map. The processor inputs the combined feature map to a second neural network to generate output information by the second neural network. The processor calculates an output error based on output information, first correct information, and second correct information.

Abstract: An ultrasound treatment tool includes: an ultrasound blade including a treatment portion located at a distal end of the ultrasound blade, a jaw configured to open and close relative to the treatment portion. The jaw includes: a surface, a contact surface facing the ultrasound blade, the contact surface configured to be in contact with the treatment portion when the jaw is closed relative to the treatment portion. The contact surface comprises: a first resin layer positioned on the surface, the first resin layer formed of a first resin, a second resin layer layered over the first resin layer, the second resin layer formed of a mixed resin, the mixed resin being a mixture of a second resin and the first resin.

Abstract: A control apparatus includes a processor. The processor detects an image pickup scene based on a picked-up image acquired by an image pickup apparatus disposed in an insertion section included in an endoscope and calculates operation information corresponding to the image pickup scene using an approach of machine learning.

Abstract: An electrosurgical system, including: an electrosurgical generator, and an electrosurgical instrument configured to connect to the electrosurgical generator through a three-pin connector; wherein the electrosurgical instrument includes an electrosurgical electrode connected to a first pin of the three-pin connector, and one of an activation switch circuit and an instrument identification circuit connected to a second pin and a third pin of the three-pin connector; wherein the electrosurgical generator is configured to detect, upon connection of the electrosurgical instrument to the electrosurgical generator, whether the electrosurgical instrument includes an activation switch circuit or an instrument identification circuit; and, if the electrosurgical instrument includes an activation switch circuit, connect the second and third pin of the three-pin connector to an activation switch unit, or, if the electrosurgical instrument includes an instrument identification circuit, connect the second and third pin of t

Abstract: An endoscope holder includes a holder body, a hanger and a slide member. The hanger is pivotably attached to the holder body to move between a first angle position and a second angle position. The slide member is supported on the holder body. The slide member is configured to move slidably between a first position and a second position. At the first position, the slide member restricts pivoting of the hanger from the first angle position to the second angle position. At the second position, the slide member permits pivoting of the hanger from the first angle position to the second angle position. When the hanger is at the first angle position, the hanger is configured to support an endoscope by hanging the endoscope on the hanger. When the hanger is at the second angle position, the hanger is configured to not support the endoscope by hanging.

Abstract: In order to provide an endoscope that can reduce imbalance in shrinkage of an insertion portion and imbalance in slackening of bending wires even if a sterilization process involving heating is performed with respect to the endoscope stored in a container or the like while achieving the downsizing of a storage form used to store the endoscope in the container or the like, the endoscope package system includes an endoscope, the endoscope includes: a flexible insertion portion; in a length direction of the flexible insertion portion, the flexible insertion portion has a shape that includes a first winding direction and a second winding direction, the first winding direction is different from the second winding direction.

Abstract: An operation body for use with an insertion instrument. The operation body including: a pulley having a first outer circumferential surface, the pulley configured to rotate about a rotational axis to bend a bending portion; a lock operation member; and a brake member including an inner circumferential brake surface disposed between the first outer circumferential surface and the lock operation member. Wherein when the lock operation member is actuated, the inner circumferential brake surface is configured to contact with the first outer circumferential surface of the pulley along a circumferential length of the inner circumferential brake surface to restrict rotation of the pulley.

Abstract: A treatment tool can include an end effector comprising an ultrasonic blade, a tubular portion coupled to the end effector, and a driver coupled to a proximal end of the tubular portion. The driver can be configured to actuate the end effector via the tubular portion. The treatment tool can further include a pusher configured to support a coupling between the tubular portion and the driver in order to prevent a movement of the tubular portion in a longitudinal direction thereof.

Abstract: An image pickup unit includes: an image pickup device; a flat circuit board; a three-dimensional circuit board; plural electronic components; and plural cables, in which the three-dimensional circuit board includes: a first surface; a second surface; a third surface; a fourth surface; a fifth surface; and a sixth surface, in which on one of the first surface to the sixth surface, a recessed portion is formed and a connection terminal portion is formed in an inner surface of the recessed portion, one of the plural electronic components or the plural cables is mounted on or connected to the connection terminal portion, the recessed portion is formed, in a site where the first surface and the sixth surface cross each other, from the second surface toward the third surface, the recessed portion having a wall surface parallel to the second surface, and one of the electronic components is mounted.

Abstract: An image processing device includes a processor comprising hardware. The processor calculate based on an endoscope image of a subject, the endoscope image being acquired by an endoscope, three-dimensional position information regarding a first treatment tool and a first portion in the endoscope image. Additionally, the processor measures a distance between the first measurement point on a distal end side of the first treatment tool and a second measurement point associated with the first portion based on the three-dimensional position information regarding the first treatment tool and the first portion, and perform a determination of whether a measurement of the distance is in a stable state and control a display to display a result of the determination.

Abstract: An electrosurgical system including an electrosurgical instrument and generator to which the electrosurgical instrument is connected. The electrosurgical generator has a processor, one generator data memory and optical and our acoustic signaling and/or display providing optical and/or acoustic notifications to a user during the operation of the electrosurgical generator. The electrosurgical instrument has one instrument data memory in which a data set with structured data is stored, wherein some of this data represent signaling instructions, based on which the processor can control the output of optical and/or acoustic notifications for a user during the operation of the electrosurgical generator.

Abstract: A bending mechanism extending along an axis from a first side to a second side includes a first tube bendable by a wire being pulled, a cylindrical first guide disposed in the first tube along the axis to guide the wire, a second guide coupled to the first tube to hold the first guide, a second tube disposed along the axis closer to the first side than the first tube, and a third guide disposed in the second tube along the axis. The first guide is inserted into the third guide and extends beyond a first-side end of the first tube to an intermediate position in the third guide. A portion of the first guide inside the third guide has, when the first tube is straight, a length sufficient to maintain a first-side end of the first guide inside the third guide even when the first tube is bent.

Abstract: An endoscope includes: an insertion section including a distal end and a proximal end, the insertion section configured for insertion into a subject; an operation section main body connected to the proximal end of the insertion section and, the operation section main body configured to be grasped by a user. The operation section main body includes an operation knob and a switch button. The operation knob is rotatable about a center axis to move the distal end of the insertion section. The switch button is translatable in a translating direction. In a view in a longitudinal direction of the operation section main body, the center axis of the operation knob is configured to be tilted with respect to a direction that is perpendicular to each of the longitudinal direction of the operation section main body and the translating direction of the switch button.

Abstract: An image processing apparatus includes a processor that generates a three-dimensional image of a subject from a first image acquired by an endoscope before an acquisition of a second image, associates a position of boundary information of a lesion included in the second image with the second image, and associates the position of the boundary information associated with the second image with the three-dimensional image. The first and second images are two-dimensional images of the subject. The processor: calculates a relative position between a treatment tool in a two-dimensional third image acquired by the endoscope after the acquisition of the second image and a camera of the endoscope; calculates a position of the camera in the three-dimensional image; calculates a position of the treatment tool in the three-dimensional image; determines a positional relationship between the treatment tool and the boundary information; and outputs support information based on a determination result.

Abstract: An information processing system, including a processor comprising hardware. The processor being configured to: acquire an endoscope image from an endoscope, the endoscope image showing a papillary portion, determine route information of a lumen based on the endoscope image, the lumen being at least one of a biliary duct or a pancreatic duct, generate a display image based on a result of the determination of the route information of the lumen, the display image having a route guide image to provide guidance of a route of the lumen leading to the papillary portion superimposed on the endoscope image, and display the display image on a display.

Abstract: An endoscope puncture needle including a tubular portion that includes first and second needle tip portions at a distal end thereof. The first needle tip portion includes a first needle tip at a distal end, and first and second blade surfaces extending towards the first needle tip. The second needle tip portion includes a second needle tip at a distal end, and third and fourth blade surfaces extending towards the second needle tip. The first blade surface and the third blade surface face in directions approaching each other, and the second blade surface and the fourth blade surface face in directions approaching each other.

Abstract: Provided is a laminated optical system that has a wide angle of view and is environmentally resistant by suppressing changes in performance due to temperature changes. The laminated optical system includes four lens portions, and in each lens portion, a parallel flat plate and a plano-concave lens or a plano-convex lens having a partially curved surface are adhered to each other. In each lens portion, the linear expansion coefficient of the plano-concave lens or the plano-convex lens is greater than the linear expansion coefficient of the parallel flat plate.

Abstract: A rigidity control apparatus includes a processor and controls a variable-rigidity apparatus. The variable-rigidity apparatus includes a variable-rigidity member, flexural rigidity of which increases when the variable-rigidity member is heated, and a heater configured to be able to heat the variable-rigidity member. The processor calculates information about temperature of the heater, and estimates information about temperature of the variable-rigidity member based on the information about the temperature of the heater.

Abstract: A method for documenting a reprocessing of a reusable medical device. The reusable device comprising at least one temperature sensor configured to provide temperature data representing a temperature of the medical device, a real time clock (RTC) configured to provide timestamps and one or more processors including hardware configured to process the temperature data and the timestamps. The method includes: monitoring the temperature of the medical device during the reprocessing; and a) upon detecting the temperature exceeding a first predefined threshold, the one or more processors receiving and saving a first current timestamp provided by the RTC, and setting the one or more processors into a low-power mode, and b) upon detecting the temperature falling below a second predefined threshold, setting the one or more processors into an active mode, and the one or more processors receiving and saving a second current timestamp provided by the RTC.

Abstract: An image processing device includes a processor comprising hardware. The processor calculate based on an endoscope image of a subject, the endoscope image being acquired by an endoscope, three-dimensional position information regarding a first treatment tool and a first portion in the endoscope image. Additionally, the processor measures a distance between the first measurement point on a distal end side of the first treatment tool and a second measurement point associated with the first portion based on the three-dimensional position information regarding the first treatment tool and the first portion, and perform a determination of whether a measurement of the distance is in a stable state and control a display to display a result of the determination.