Abstract: An ultrasound probe includes: an ultrasound transducer array in which a plurality of ultrasound transducers configured to transmit and receive ultrasound are arrayed; a backing layer provided on a proximal end surface of the ultrasound transducer array; and a piezoelectric element, provided on a proximal end surface of the backing layer, whose direction of polarization is opposite to a direction of polarization of the plurality of ultrasound transducers.

Abstract: An image processing apparatus includes a processor including hardware, the processor being configured to: determine whether or not an overlapping portion is present in imaging areas included in a plurality of images captured by a plurality of imagers, respectively, the plurality of imagers being are inserted into a subject to capture images of an observation target at different positions from each other; determine whether or not each of the plurality of imagers is inserted to a focal point position at which the observation target is in focus; and generate a composite image that is composed of the plurality of images when it is determined that each of the plurality of imagers is inserted to the focal point position and that the overlapping portion is present in the imaging areas.

Abstract: An endoscope treatment tool that is insertable into a channel of an endoscope includes: an insertion unit having flexibility; and a treatment unit disposed on a distal end of the insertion unit and supported so as to be rotatable about a longitudinal axis of the insertion unit. The insertion unit includes a tubular exterior member configured to come into contact with the treatment unit on a distal end side of the insertion unit, the tubular exterior member configured to be moved in a direction of the longitudinal axis of the insertion unit, an operation member penetrating through an interior of the exterior member, the operation member configured to transmit rotation about the longitudinal axis to the treatment unit, and a wire penetrating through an interior of the insertion uni, the wire having a distal end fixed to the exterior member.

Abstract: Provided is a method of manufacturing a vibration transmission member for an ultrasonic treatment tool. The method includes: applying a release agent between a surface of a vibration transmission member configured to transmit ultrasonic vibration and a die for hot forging; performing hot forging to form the vibration transmission member after the applying of the release agent; removing, after the performing of the hot forging, a part of an oxide film formed in the performing of the hot forging by a first surface treatment; performing pickling to remove the oxide film after the removing of the part of the oxide film by a blasting treatment; and performing coating with a resin after the performing of the pickling.

Abstract: A vibration transmission member includes a main body, a treatment portion that is provided at the distal end of the main body, a first covering formed of a material that has an electrical insulating property and has a thermal conductivity lower than a thermal conductivity of the main body, which covers a part of a surface of the treatment portion, and a second covering formed of a material that has an electrical insulating property and has a thermal conductivity lower than the thermal conductivity of the main body. The second covering is integrally formed with at least a part of the first covering and varies in thickness in a circumferential direction of the main body. The second covering includes a first area and a second area in the circumferential direction, such that a thickness dimension of the first area is smaller than a thickness dimension of the second area.

Abstract: Provided is a cooling device of an endoscope device. The cooling device includes: a box; a first communicating hole that is a hole provided in the box; a second communicating hole that is a hole provided in the box; a second fan that is provided at the second communicating hole, the second fan being configured to guide gas to an exterior of the box through the second communicating hole to generate an airflow in the box, the gas having introduced into the box from the first communicating hole; and a duct configured to house a heat generator to be cooled, the duct being positioned in the box to allow the airflow to pass through an inside of the duct.

Abstract: A cover stent includes: a mesh tube knitted into a tube by a wire including a first bending portion protruding toward a first end portion in a longitudinal direction of the tube and a second bending portion protruding toward a second end portion opposite to the first end portion in the longitudinal direction, the first and second bending portions intersecting each other by being twisted once; a cover covering outside or inside of the mesh tube; and a restricting member connected to the cover with a space, the wire in at least one of the first and second bending portions being movably inserted into the space along a surface of the cover. The mesh tube is connected to the cover by the restricting member so that the first and second bending portions can move relative to each other along the surface in the longitudinal direction.

Abstract: An image processing system includes a processor configured to acquire a processing target image, perform a classification process that classifies an observation method when the processing target image is captured to a first observation method or a second observation method based on an observation method classifier, perform a selection process that selects one of a plurality of detectors of region of interest for detecting a region of interest including a first detector of region of interest and a second detector of region of interest based on a classification result of the observation method classifier, and output a detection result based on the selected detector of region of interest.

Abstract: An inverted microscope apparatus includes an immersion objective, an electric stage that moves at least in a direction orthogonal to an optical axis of the immersion objective, and a removal mechanism that removes an immersion liquid adhering to a bottom surface of a container placed on the electric stage. The removal mechanism is configured to scan the bottom surface using movement of the electric stage.

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: A treatment device equipped with high frequency capability includes a pair of clasping jaws that serves as bipolar electrodes. Another treatment device equipped with high frequency capability includes a high-frequency knife that serves as monopolar electrode. An anti-fouling coating that minimizes or prevents adhesion of cauterized tissues is incorporated on the electrode surfaces. Durability and functioning of the anti-fouling coating is improved by one or a combination of increased coating thickness, increased density of the coating, and incorporation of glass and/or high molecular weight PFPE into the coating. The anti-fouling coating can be applied to different locations of the treatment portion, e.g., an insulated portion and a recess of an electrode, an insulated portion and a boundary portion with an electrode.

Abstract: An image processing apparatus includes an input unit, an estimation unit, an acquisition unit, a production unit, and a display control unit. The input unit acquires examination information including an endoscope image. The estimation unit estimates an image pickup site based on the endoscope image. The acquisition unit acquires, from the examination information, image pickup information corresponding to the endoscope image and indicating a state of at least one of an endoscope or a subject when the endoscope image is picked up. The production unit produces a model map and associates the image pickup information with a virtual site based on a result of the estimation by the estimation unit. The display control unit controls a display device.

Abstract: A focus control device includes a processor. The processor analyzes detection results of a target object in time sequence to determine whether the target object is in a lost state in which the target object is not temporarily captured into an image, sets a focus drive mode to an autofocus mode when the target object is detected, sets a first positional mode in which the focus lens is arranged at a position that is within a set range of an in-focus object plane position and is on the far point side of a central position when the target object is not detected and is not in the lost state, and sets the focus drive mode such that a lens position is nearer to a near point than in the first positional mode or sets the focus drive mode to the autofocus mode in a when the lost state is determined.

Abstract: An ultrasound transducer unit includes: a plurality of units each of which includes a piezoelectric element group, a wiring substrate that includes a plurality of wiring lines that are electrically connected to piezoelectric elements included in the piezoelectric element group, and a cable group that is electrically connected to the wiring lines included in the wiring substrate, that extends in a direction intersecting a longitudinal direction of each of the piezoelectric elements included in the piezoelectric element group, and that is formed into a helical shape; an outer surface support that supports, by using an outer surface of the outer surface support, the piezoelectric element group included in each of the plurality of units; and an inner surface support that supports an inner surface of the outer surface support. Cable groups included in the plurality of units constitute a multiple helical structure.

Abstract: A medical image data creation apparatus for training acquires a first medical image, acquires a second medical image that is different from the first medical image and is obtained by photographing a substantially same spot as in the first medical image, creates lesion region information concerning a lesion part in the second medical image, and creates medical image data for training in which the first medical image and the lesion region information are associated with each other.

Abstract: An endoscopic bendable tube includes: an integrally formed resin tube; at least two wires embedded in a tube wall of the resin tube from a proximal end side to a distal end side of the resin tube, the at least two wires being parallel to a tube axis direction of the resin tube and being at positions facing each other; and a plurality of pairs of through slits formed in the tube wall of the resin tube in the tube axis direction, each pair of through slits being formed facing each other in the tube wall of the resin tube.

Abstract: An information processing apparatus include a processor configured to: control a display to display at least a partial image of a captured image generated by capturing an image of an observation target; generate field of view information by associating: display position information indicating a position of a display area corresponding to the displayed partial image; magnification information indicating a display magnification of the partial image; and time information indicating a display time of the partial image; record the field of view information in a memory; and extract a piece of the field of view information including the magnification information indicating at least a single kind of specific display magnification input to an input device from among pieces of the field of view information recorded in the memory; generate a field of view map image corresponding to the extracted piece of field of view information; and control the display to display the field of view map image.

Abstract: An image pickup apparatus includes an image pickup member including an image pickup device, a stacked device in which a plurality of semiconductor devices are stacked, a wiring board having a first principal surface and a second principal surface, the wiring board including a central section having a substrate thicker than the image pickup device, an intermediate section that is extended from the central section and is bent, and a terminal section that is extended from the intermediate section, the image pickup member being bonded to the first principal surface of the central section, the stacked device being bonded to the second principal surface of the central section, and a plurality of signal cables bonded to the terminal section.

Abstract: A treatment system that includes a treatment instrument to apply a treatment energy to a living tissue from an end effector according to a supplied electric power to incise the living tissue, an imaging device to generate a captured image capturing a state in which the treatment energy is applied from the end effector to the living tissue, and a control device that includes a processor to control operation of the imaging device. The processor acquires the captured image, calculates a temporal change amount based on any one of a predetermined point and a predetermined area in the captured image as a determination value, determines whether incision of the living tissue has been completed based on the determination value, and in response to determining that incision of the living tissue has been completed, execute an instruction to stop supply of the electric power to the treatment instrument.

Abstract: A treatment device and an endoscopic treatment method are disclosed. The treatment device includes a first pipeline that is made of material having electrical insulation, and includes an internal space; an electrode that is energizable with high frequency current; a distal-end tip that is attached to a distal end of the first pipeline, and includes a distal-end opening in communication with the internal space of the first pipeline; and a second pipeline that is inserted through the first pipeline and through which liquid can pass. The endoscopic treatment method includes puncturing a treatment target and performing a local injection using the treatment device.

Abstract: A control device includes: a processor configured to obtain a first picture signal and a second picture signal, calculate first ranging information based on the first picture signal, calculate second ranging information based on the second picture signal, estimate a first subject distance corresponding to the first ranging information, estimate ranging information corresponding to a second focal position, perform arithmetic processing to determine degree of reliability of the first ranging information, and output a result of the arithmetic processing.

Abstract: A display control apparatus includes a processor, and the processor determines, in work on an object within a space, which one of a first picked-up image by a first image pickup device disposed at a first predetermined position within the space and a second picked-up image by a second image pickup device disposed at a second predetermined position different from the first predetermined position within the space is appropriate for confirmation of procedure in a state associated with the work on the object using a treatment instrument, outputs a determination result and controls display using at least one of the first picked-up image or the second picked-up image based on the determination result.

Abstract: A treatment device includes a pipeline having electrical insulation, the pipeline having an internal space through which inert gas passes; a distal-end tip attached to a distal end of the pipeline, the distal-end tip having an opening formed to communicate with the internal space such that the inert gas is disposable from the opening; and an electrode provided in the distal-end tip and configured to be energizable with a high-frequency current. The pipeline includes a proximal-end bending portion with a bending habit, and a distal-end flexible portion without a bending habit that is disposed distal to the proximal-end bending portion.

Abstract: An image processing apparatus includes a processor. The processor receives endoscope images to be determined, in each of which an image of an inside of a body of a subject is picked up, determines whether or not an endoscope image for comparison concerning a predetermined inspection site, and the endoscope images to be determined are same or similar, determines whether or not an observation mode of each of the endoscope images to be determined is a condition suitable for automatic recording, and automatically records a predetermined number of the endoscope images to be determined in a recording unit, when the endoscope images to be determined and the endoscope image for comparison are determined to be the same or similar and when the observation mode is the condition suitable for automatic recording.

Abstract: An observation system includes: an observation device that includes an eyepiece lens and an objective and forms a real image of a sample on an optical path between the eyepiece lens and the objective; and an observation auxiliary device that is worn by a user and outputs auxiliary information to the user, the observation auxiliary device superimposing the auxiliary information on a virtual image of the sample to be observed by the user through the eyepiece lens on the basis of a relative position of the observation auxiliary device with respect to the observation device.

Abstract: An endoscope system includes: an endoscope comprising a first tube being inserted into a body, a second tube being arranged at a proximal end of the first tube, and a connecting portion connecting the first tube and the second tube so that the first tube can rotate relative to the second tube about a longitudinal axis; and a control device comprising at least one processor. The processor estimates a first guess shape based on information about positions of a plurality of points on the first tube, and estimates a second guess shape based on information about positions of two points on a proximal end side of a region of the first tube inserted into the body.

Abstract: An endoscope includes: an insertion portion having a joint; a first wire and a second wire fixed on both sides of a central axis in a longitudinal direction of the joint at a distal end of the joint; a first wire sheath which is inserted through an internal path of the insertion portion and through which the first wire is inserted; and a second wire sheath which is inserted through the internal path of the insertion portion and through which the second wire is inserted, wherein the first wire sheath is bundled by a first fastener so as to be close to the second wire sheath, and the first wire sheath and the second wire sheath are bundled so as to be relatively advancing and retreating by the first fastener.

Abstract: A treatment system includes a treatment tool, an imaging apparatus, and a control device. The treatment tool is configured to perform treatment on a living tissue by applying treatment energy from an end effector to the living tissue based on supplied electric power. The imaging apparatus captures an image of the living tissue in a state in which the treatment energy is applied from the end effector to the living tissue. The control device includes a processor to control the imaging apparatus by acquiring the captured image, determining whether an abnormality has occurred in the end effector based on the acquired captured image, and executing an instruction to stop supply of the electric power to the treatment tool when determining that the abnormality has occurred in the end effector.

Abstract: An endoscope reprocessor includes: a pump; a port; a tube connected to the port; a connector disposed in the tube and connected to a pipe sleeve of a treatment instrument channel, which is a pipe of an endoscope, and configured to allow a fluid to be leaked from a connection region of the connector to the pipe sleeve to an outer circumferential surface of the pipe sleeve; a valve disposed in a flow path; a pressure sensor configured to measure a pressure of the fluid; and a processor configured to repeatedly control the valve such that the valve is closed when the pressure exceeds a first pressure and the valve is opened when the pressure is lower than a second pressure, and determine a feeding state of the fluid based on a time period until an opening/closing number of the valve reaches a predetermined number more than one.

Abstract: A treatment tool includes: a sheath extending along a longitudinal axis; a fixed gripping piece protruding from a distal end of the sheath; a movable gripping piece that is movably attached to either the sheath or the fixed gripping piece, the movable gripping piece being configured to grip a living tissue between the movable gripping piece and the fixed gripping piece; and a movement restricting portion configured to allow movement of the movable gripping piece in a first range and restrict movement of the movable gripping piece in a second range different from the first range. The movable gripping piece is attachable to and detachable from either the sheath or the fixed gripping piece at a movement position within the second range.

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: An image processing system includes a processor configured to acquire, as a processing target image, an in-vivo image, operate in accordance with a trained model, and output a recognition result representing a result of recognition of a region of interest in the processing target image. The trained model is trained by having undergone pre-training using a first image group including images captured in a first observation method, and having undergone, after the pre-training, fine-tuning that uses a second image group including images captured in a second observation method, as well as that uses ground truth regarding the region of interest included in the second image group. The first observation method is an observation method using normal light as illumination light, and the second observation method is an observation method using special light as the illumination light or an observation method in which a pigment has been dispersed onto the subject.

Abstract: A medical system according to the present invention comprises: a medical device comprising an insertion part comprising an angulating part, and angulation wires attached to the angulating part; and an actuator, detachably connected to the medical device, that electrically actuates the angulation wires to angulate the angulating part. The angulation wires comprise a first angulation wire and a second angulation wire. When the medical device is not attached to the actuator, the first angulation wire and the second angulation wire are in a mechanically connected looped state. When the medical device is connected to the actuator, the first angulation wire and the second angulation wire are in a second state in which the two are independently electrically actuated.

Abstract: A method for closing a wound in a tubular organ using a suture thread attached to a suture needle. The method includes grasping a first part of the suture thread by a grasper inserted in the tubular organ after the suture thread has been passed through tissue surrounding the wound at a first position; moving the first part away from the first position by moving the grasper grasping the first part along a longitudinal axis of the grasper; grasping a second part of the suture thread located between the first part and the first position by the grasper; and moving the second part away from the first position by moving the grasper grasping the second part along the longitudinal axis of the grasper.

Abstract: A liquid feeding conduit includes: a tube body of a cleaning tube through which a fluid passes; an endoscope-side connector provided at an end of the tube body, the endoscope-side connector being connected to a conduit cap of an endoscope conduit; a valve element provided in the endoscope-side connector, the valve element being configured to move toward a side of the conduit cap by a supply pressure of the fluid to thereby watertightly connect the endoscope-side connector and the conduit cap; a spring configured to bias the valve element toward an opposite side of the conduit cap; and a buffer unit configured to delay the movement of the valve element toward the side of the conduit cap.

Abstract: The image processing system includes a scanner, a pixelated photon detector (PPD), and at least one processor. The at least one processor displays a setting screen on a display unit. The setting screen is a screen for setting an identification range that is a range of gradation to be identified. The at least one processor displays a second image obtained by converting a first image on the display unit. The second image is an image obtained by converting the first image based on at least the identification range. The first image is generated based on an intensity signal of light detected by a PPD and a scanning position by the scanner.

Abstract: A medical support apparatus has one processor or more, and the processor is configured to: acquire a medical image; and based on the medical image, generate a guidance display that indicates a boundary between segments whose recommendation levels for medical treatment are different in the medical image and that is to be superimposed on the medical image.

Abstract: A heating blade unit, a treatment tool, and a method of manufacturing a heating blade unit are disclosed. The heating blade unit includes: an electric heater, a blade, and a cover made of a thermosetting resin. The blade includes a treatment surface, an installation surface that is provided on a side opposite to the treatment surface and on which the electric heater is installed, and a support surface that is provided at a position different from a position at which the installation surface is provided. The cover integrally covers the electric heater, and one or more surfaces of the blade.

Abstract: An electrode instrument, a surgical handheld device and a production method, by means of which the quality of the aforementioned instruments can be improved. This is achieved by virtue of an electrode instrument for a surgical handheld device having an electrical conductor which is electrically insulated by an insulation in the form of flexible tubing, wherein the conductor is pressed in an electrode carrier, wherein the electrode carrier has a cross section with six pressed sides at the pressed position.

Abstract: A treatment system includes a treatment tool and a generator. The treatment tool includes a first grasper configured to apply treatment energy to a living tissue, and a second grasper. The generator includes a power circuit, a detecting circuit configured to detect an index value indicating a treatment state of a test material, and a processor configured to, based on the index value, measure a treatment completion time. At least one of the treatment tool and the generator further includes a memory configured to store property data which indicates a property of the test material, and based on the measured treatment completion time, the intensity of the treatment energy applied to the test material, and the property data, the processor is configured to calculate a control parameter related to the intensity of the treatment energy when the living tissue is treated, and output the control parameter to the power circuit.

Abstract: A device for evaluating progression of differentiation from pluripotent stem cells to pigment-containing cells includes a first irradiation unit configured to irradiate cells in a vessel with light in a melanin absorption wavelength band, a first detection unit configured to detect photo-acoustic waves generated from the cells irradiated with the light, and a processor configured to output an evaluation result relevant to the progression of the differentiation of the cells to the pigment-containing cells, based on intensity of the detected photo-acoustic waves detected by the first detection unit.

Abstract: An endoscope includes: a composite cable in which a plurality of cables each including a core wire and an electric insulating coated portion coating the core wire are bundled with an electric insulating outer sheath; a substrate that includes electrodes to which the respective cables are connected; and a cable fixing portion that includes a cable distal end fixing portion holding the plurality of cables in which the core wire and the coated portion are exposed from a distal end surface side of the composite cable, a cable alignment portion aligning the plurality of cables, and a cable body fixing portion holding an end portion of the composite cable on a side where the plurality of cables is exposed, and provided with a through hole having a diameter same as a diameter of an outer periphery of the composite cable.

Abstract: A medical device includes a pair of jaws that grips biological tissue, is coupled at first ends of the jaws, opens and closes as a result of swiveling of at least one of the jaws, and comprises a pair of gripping surfaces facing when the jaws are closed, a motor that generates a closing driving force for closing the jaws, a driving-force transmission member that connects the jaws to the motor and that is configured to transmit the closing driving force from the motor to at least one of the jaws, and a controller that is connected to the motor and that controls the motor. The controller temporally changes magnitude of the closing driving force generated by the motor so as to shift peak positions of gripping pressure for gripping the biological tissue in the pair of gripping surfaces.

Abstract: A reception device includes a wireless communicator, a memory, and one or more processors. The processors identify a retransmission candidate of image data on the basis of a sequence number recorded on the memory. The processors calculate an upper limit retransmission number on the basis of a physical rate and a communication rate recorded on the memory. The processors set an allowable retransmission number that is less than or equal to the upper limit retransmission number. The processors transmit a retransmission request for requesting retransmission of as many of the retransmission candidates as the allowable retransmission number to the transmission device in a blanking period by using the wireless communicator when the number of the retransmission candidates identified through the identification processing exceeds the allowable retransmission number.

Abstract: A vibration transmission member includes: a main body portion configured to transmit ultrasound vibration; a treatment portion that is provided at a distal end of the main body portion, the treatment portion being configured to apply ultrasound vibration to a living tissue; a coating portion that is made of an electrically insulating material containing a first resin, the coating portion being configured to cover a part of a surface of the treatment portion; and a mold portion that is made of an electrically insulating material containing a second resin different from the first resin, and that is fused to at least a part of the coating portion.

Abstract: In an imaging system, a video output circuit is configured to convert an analog video signal into digital data and output serial data including the digital data to a signal line on the basis of a serial clock having a higher frequency than a frequency of the camera clock. A camera-clock generation circuit is configured to generate the camera clock synchronized with the system clock output to the signal line. A serial-clock generation circuit is configured to generate the serial clock synchronized with the system clock output to the signal line. A system-clock output circuit is configured to output the system clock to the signal line in a blanking period.

Abstract: Stent device has a stent cover bonding to the stent wires forming the stent body at a plurality of bonding portions that are remote from the cross over points of the stent wire. By allocating the bonding portions to the stent wires in between the cross over portions, the axial flexibility of the stent device is maintained. The stent cover bonded by the disclosed bonding portions contributes to preventing lumen tissues to penetrate into the stent body and clogging the stent while placement of the bonding portions bonding the stent cover to the stent device provides variations of positive effects to the cover stent device and to the patient in which the stent device is placed.

Abstract: A fluid distributor for use with a reprocessing device for reprocessing a surgical instrument having a plurality of channels, including: a routing body having a plurality of connections corresponding to the channels; and a switching body movably disposed in the routing body, the switching body having an interior supply line connected to a fluid reservoir for selectively providing a fluid to one or more of the connections. The switching body can be configured such that, in a first position of the switching body relative to the routing body, the connections of the routing body are each in fluid communication with the supply line of the switching body and in at least a second position of the switching body relative to the fluid routing body less than all of the connections of the routing body are in fluid communication with the supply line of the switching body.

Abstract: In order to flush away local bleeding during surgery with a medical instrument, the instruments are commonly provided with a flushing device. In order to be able to control an inflow and outflow of a flushing liquid, the instruments have a stopcock. In order to achieve the sealing action of the stopcock, the plugs of the stopcock have to be formed with a very high degree of precision. The known production processes for such plugs are very cumbersome and cost-intensive. This provides a plug for a stopcock and a stopcock and a method for producing a plug, by way of which the stated problem is eliminated. This is achieved in that a plug, with a grip part and a cone part, is formed in one part and can be produced in a single process step.

Abstract: A clip device includes a restraining tube having an insertion passage with a first arm part and a second arm part facing each other and disposed within the insertion passage and configured to protrude from the restraining tube. The clip device further includes an operation wire configured to move the first arm part. A first stopper is engaged to the first arm part and a second stopper is engaged to the second arm part. The first stopper is disposed in a region closer to a distal end of the restraining tube than the second stopper. The first stopper is configured to, in response to the operation wire moving from the distal end of the restraining tube to a proximal end of the restraining tube, move relative to the second stopper, contact the second stopper, and move in contact with the second stopper.