Abstract: An endoscopic treatment method includes: inserting an endoscope into a digestive tract; forming a damaged area in at least a portion of the digestive tract along a circumferential direction by performing cauterizing while keeping a mucosal layer by observing with the endoscope; and forming an incomplete stenosis in the digestive tract, while restoring the damaged area, wherein the damaged area is formed by causing damage to a mucosal base layer, the mucosal base layer having an interface that contacts a submucosal layer.

Abstract: A bending portion of an endoscope according to the disclosure includes: a plurality of bending pieces rotatably coupled to each other by a coupling fastener; a wire configured to transmit a traction operating force to a first bending piece included in the plurality of bending pieces; and a pin located in a first hole in the first bending piece, the pin connecting the wire to the first bending piece, a first end portion of the pin protruding from an outer circumference of the first bending piece, a second end portion of the pin protruding from an inner circumference of the first bending piece, a third portion of the pin contacts a surface of the first hole. A first width dimension of the first end portion is larger than an opening dimension of the first hole, the wire is attached to the second end portion.

Abstract: A method for self-checking of an endoscope reprocessing device having a fluid source, supply channels for supplying the fluid to endoscope channels of an endoscope(s) connected with the supply channels, and a controller for controlling the reprocessing of endoscope(s). Each of the supply channels having a switchable valve configured to block or unblock the supply channel in response to a control signal. The method including: reprocessing the endoscope(s); carrying out a running self-check of the reprocessing device comprising keeping a history of flow test results, updating the history with latest flow test results and carrying out an analysis of the history of flow test results for each of the supply channels; and indicating a problem with one or more supply channels or a valve associated therewith if the history of flow test results contains one or more flow test result anomalies that meet at least one or more predefined criteria.

Abstract: A stent device including a stent cover having differing porosity ratio is disclosed. The stent covers the stent body comprising of stent wires and stent cells enclosed by the stent wires. The stent cover differs in porosity ratio for areas covering the stent wires and the areas covering the stent cells. The porosity ratio for areas covering the stent wires may have a higher porosity rate in order to promote endothelialization of the stent device. A bilayer stent cover differing in porosity ratio may be used to cover the stent body, as well as stent cover not covering the entirety of the stent body.

Abstract: A light source device includes: a fluorescent material configured to rotate about a rotation axis, and emit fluorescence upon reception of excitation light; a light source configured to emit the excitation light; an optical filter that is arranged to cover a part of the fluorescent material from a direction along the rotation axis, the optical filter being configured to pass light of some wavelength band in the fluorescence generated by excitation of the fluorescent material; and a first processor configured to control a rotation operation of the fluorescent material about the rotation axis, and an operation of the light source.

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: An imaging device includes a camera unit and a control unit. A first power source voltage is transferred from the control unit to the camera unit by a power source line and is input to the camera unit as a second power source voltage. The control unit measures a value of a voltage generated at a point connecting the power source line and the control unit. The voltage at the point is generated based on both the second power source voltage held in a capacitor of the camera unit and a resistance component of the power source line. The control unit calculates a resistance value of the power source line based on the measured value. The control unit adjusts a value of the first power source voltage based on the resistance value.

Abstract: A clip device for gripping biological tissue of a patient includes a clip having a first arm and second arm closeable by operation of a wire that is reciprocally moveable in a longitudinal channel of a sheath; and a bendable member at a distal end region of the sheath. The bendable member can be an integral portion of the sheath or a separate structure. The bendable member is configured to allow a distal end of a clip to rotate or swing toward a proximal end region of the sheath of the device, which orients the clip relative to the sheath to facilitate grasping of tissue even when the approach of the clip is tangential to the tissue, e.g., at an angle (?) less than 90. The bendable member can be configured to allow a distal end of a clip to rotate or swing toward a proximal end region of a sheath and form an angle of up to at least about 45 degrees, such up to about 60 degrees or up to about 90 degrees, or higher.

Abstract: A method for producing an electrode and an electrode. An electrode for an electrosurgical handheld instrument includes an electrically conductive wire made of a plurality of portions. In this case, two portions of the wire R1 and L1, which directly adjoin two ends of the wire, are aligned both parallel to one another and straight. Moreover, the two first portions R1 and L1 are adjoined by two second portions R2 and L2, which are likewise aligned both parallel to one another and straight. In this case, the portion R2 directly adjoins the portion R1 and the portion L2 directly adjoins the portion L1. The two portions R2 and L2 in turn are connected to one another via a further portion.

Abstract: An insulation insert, an electrode carrier and an electrosurgical handheld instrument which can be used particularly efficiently and which is producible particularly cost-effectively. This is achieved by virtue of the insulation insert having a tube-like embodiment and being detachably couplable by way of a proximal end region to a distal end of a tube-like shaft of the handheld device and a central passage serving to accommodate an inner shaft of the handheld device. Two drilled holes for accommodating a respective electrode carrier tube of an electrode carrier are arranged opposite one another in a wall of the insulation insert and parallel to the central passage.

Abstract: An imaging device includes a pixel and a voltage generation circuit. The pixel is configured to operate based on a power source voltage and a reference voltage that is lower than the power source voltage and is higher than or equal to a ground voltage. The voltage generation circuit is configured to generate a predetermined positive voltage that is higher than the reference voltage and is lower than the power source voltage. A transfer transistor of the pixel is formed on a well. The predetermined positive voltage is applied to the well. The transfer transistor is configured to operate based on the power source voltage and the reference voltage.

Abstract: An endoscope including: a shaft assembly; and a handle assembly. The shaft assembly includes: a fiber tube; an outer shaft tube arranged around the fiber tube; and a support proximally extending from the outer shaft tube. The handle assembly is arranged around the support, and an electrical connection is arranged on an outer surface of the support extending from a proximal end of the support in a distal direction such that the electrical connection is arranged at least in part between the support and the handle assembly.

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 first power source voltage transferred from a control unit by a power source line is input to an imaging device as a second power source voltage. The imaging device generates a first voltage in a first period and generates a second voltage in a second period. The imaging device generates a reference voltage. The imaging device outputs a first signal indicating the first voltage and the reference voltage to a video signal line and outputs a second signal indicating the second voltage and the reference voltage to the video signal line. An amount of current consumption in the imaging device in the first period is less than an amount of current consumption in the imaging device in the second period.

Abstract: A bending tube of an insertion appliance includes a first region including a first plurality of slits, a second region provided proximally relative to the first region and including a second plurality of slits, and a guiding surface on an inner circumferential surface of the bending tube, the guiding surface extending in a circumferential direction, and including a channel configured to slidably house a wire. Each slit of the first plurality of slits is at different position in the circumferential direction, and at different positions in a longitudinal direction. Each slit of the second plurality of slits is provided at different position in the circumferential direction, and at different position in the longitudinal direction. The first plurality of slits is distributed over a first angle in the circumferential direction, and the second plurality of slits is distributed over a second angle smaller than the first angle in the circumferential direction.

Abstract: An imaging device includes a camera unit and a control unit. A first power source voltage is transferred from the camera unit to the control unit by a power source line and is input to the camera unit as a second power source voltage. The camera unit consumes the second power source voltage as a load current in a voltage-monitoring period. The control unit measures a value of the second power source voltage transferred from the camera unit by the video signal line in the voltage-monitoring period. The control unit adjusts a value of the first power source voltage in the video output period based on the measured value.

Abstract: An endoscope includes an insertion portion, an operation portion, and a fitting mechanism coupling the insertion portion and the operation portion so as to be decouplable. The fitting mechanism includes a plate portion and a convex portion, and a fitted-shape portion and a hole. The convex portion is fitted to the fitted-shape portion. The hole exposes at least one of the plate portion or the convex portion to outside. The fitting mechanism is provided at a position around a center axis, corresponding to a bending wire.

Abstract: A signal cable includes: a plurality of electric wires; a first insulating layer surrounding the plurality of electric wires; a shielding layer covering a circumference of the first insulating layer; a second insulating layer covering a circumference of the shielding layer; and a fixing portion fixing a distal end portion of the shielding layer, in which distal end portions of electric wires protrude more toward a distal end side than a distal end portion of the second insulating layer, the distal end portion of shielding layer is disposed nearer to the proximal end side than a distal end portion of the first insulating layer and the distal end portion of the second insulating layer, and the fixing portion fixes the distal end portion of the shielding layer in a space between the distal end portion of the first insulating layer and the distal end portion of the second insulating layer.

Abstract: A method for tracking the status of at least one medical device in a distributed medical device system includes a) determining an operational status of the at least one medical device, b) computing a digital representation of the operational status of the at least one medical device, and c) storing the digital representation in an electronic storage medium of the at least one medical device; wherein the method further d) comparing the digital representation of the operational status with a previously stored digital representation of a previously determined operational status of the at least one medical device, e) preparing a change report identifying any differences between the digital representation of the current status and the previously stored digital representation of the previously determined operational status, f) transmitting the change report to a status repository server, and g) storing of the change report in a database.

Abstract: An electrosurgical generator is provided, including: at least one interface for connecting an electrosurgical instrument to the electrosurgical generator; an electrosurgical signal generation unit for supplying an electrosurgical signal to an electrosurgical instrument connected to the electrosurgical generator; a processor configured to control the electrosurgical signal generation unit; and an instrument detection unit configured to detect the type of an electrosurgical instrument connected to the electrosurgical generator; wherein the instrument detection unit comprises a camera and an image processor, the camera being configured to acquire one or more images of an electrosurgical instrument connected to the electrosurgical generator, and the image processor being configured to analyse the one or more images to detect the type of the electrosurgical instrument; and wherein the processor is configured to control the electrosurgical signal generation unit depending on the detected type of the electrosurgical

Abstract: A manipulator system includes: a manipulator; a driving device to which the manipulator is detachably connected and which electrically drives the manipulator; a control device; a first sensor provided in the driving device; and a second sensor provided in the manipulator or the driving device. The control device is configured to perform a first step of confirming that the driving device operates normally according to electric power on the basis of an output of the first sensor, and a second step of confirming that the manipulator is connected to the driving device on the basis of an output of the second sensor. The first step includes checking whether the first sensor is normal, and the second step includes checking whether the second sensor is normal on the basis of the output of the first sensor that has been confirmed to be normal and the output of the second sensor.

Abstract: An endoscope system includes: a light source configured to emit white light having wavelength distribution of white color; an optical element configured to block at least light emitted from the light source, the at least light having wavelength band corresponding to a light absorption band with a highest peak from among light absorption bands of a medicinal substance used in phototherapy; an imaging element configured to perform imaging based on a light component which has passed through the optical element; and an image processor configured to process imaging signal obtained as a result of imaging performed by the imaging element, and generate an image.

Abstract: An information processing device of the present invention is capable of collaboration with a learning device to determine whether an image group that has been obtained in time series by the first endoscope is an image group obtained at a first time or at a second time, and to create a first inference model for image feature determination of images for the first endoscope by performing learning with results of having performed annotation on the image group that was obtained at the second time as training data, the information processing device comprising at least one or a plurality of classifying processors that classify image groups constituting training data candidates, within an image group from the first endoscope that has been newly acquired, or an image group from a second endoscope, using the image group that has been obtained at the first time, when the first inference model was created.

Abstract: An electrosurgical generator including housing and an internal circuitry to generate a high-frequency voltage and to output the generated high-frequency voltage to an electrosurgical instrument, further including at least one output socket for connection of a plug of the electrosurgical instrument. The output socket is configured as self-contained unit including: a casing configured for mounting at a front plate of the housing; a plug socket mounted at a frontal face of the casing for plugging of the electrosurgical instrument; a conductor board inserted into the casing and being configured to provide internal connections of the output socket; and a connector provided at the conductor board for a connection to the internal circuitry. Thereby the output socket is modularly exchangeable. Being self-contained, the output socket can be easily exchanged against another output socket of different functionality, allowing for easy re-configuration.

Abstract: A suction system of an endoscope includes a branch conduit including a suction pipe sleeve branching from a main conduit; a suction path provided in the suction pipe sleeve and including a first opening communicating with the main conduit; a working channel including an insertion path communicating with the main conduit; and a liquid feed tube inserted through the main conduit and the working channel. A first minimum length A, a maximum length B, and a second minimum length C have a dimensional relation of C?B<(A?B)/2, the first minimum length A passing through a first center on a plane of the first opening, the maximum length B passing through a second center on a cross section orthogonal to a longitudinal direction of the liquid feed tube, the second minimum length C passing through a third center on a cross section orthogonal to a longitudinal direction of the insertion path.

Abstract: An implant with which prostates of different sizes can be treated is achieved by the fact that the length of a deployed implant is modifiable to a variable extent. Through the change of length of a stretched-out wire structure of the implant, the implant can be adapted individually to the patient anatomy and the outcome of treatment can thus be improved.

Abstract: An optical device includes: an optical system including a moving lens that moves in a direction along an optical axis; a moving frame including a first magnetic body and configured to hold the moving lens; a holding frame formed into a cylindrical shape by a non-magnetic body and configured to movably hold the moving frame on an inner circumferential surface along the optical axis, a drive unit including a magnet and configured to cause the moving frame to move in the direction along the optical axis; and second magnetic bodies arranged between the drive unit and the moving frame and configured to transmit a magnetic force of the magnet to the first magnetic body of the moving frame.

Abstract: Provided is an endoluminal device system including: an elongated and flexible endoluminal device; a wire that is disposed in the endoluminal device; a first sensor that detects tension of the wire; a second sensor that detects displacement of the wire; a driving device capable of pulling the wire; and a processor. The processor is configured to: cause the driving device to execute a relaxing operation for relaxing the wire, acquire the tension and the displacement of the wire during the relaxing operation, which are detected by the first sensor and the second sensor, respectively, and adjust a control parameter of the endoluminal device based on a rate of change in the tension with respect to the displacement.

Abstract: An endoscope connection mechanism includes a connection pipe sleeve including a hole having an axis, and a first optical shutter movable between a first state and a second state. The first optical shutter includes a first, a second and a third portions. The first portion includes a first end fixed to a base portion of the first optical shutter, and a second end provided distally relative to the first end. The second portion includes a third end connecting to the second end, and a fourth end provided distally relative to the third end. The third portion includes a fifth end connecting to the fourth end, and a sixth end provided distally relative to the fifth end. In the first state, the third portion is positioned to intersect the axis of the hole, and in the second state, the third portion is positioned not to intersect the axis of the hole.

Abstract: An image pickup unit includes a rear group lens barrel which holds the rear group lens, a moving lens barrel which holds the moving lens and which is movable to advance and retreat inside the rear group lens barrel along an optical axis of the observation optical system, an actuator which includes a guide tube and a head member and which is configured to transmit motive power to the moving lens barrel by advance and retreat movement of the head member with respect to the guide tube, and a second stopper member which is positioned and fixed to the rear group lens barrel and which defines a retreat position in a direction of the optical axis of the moving lens barrel, in which the second stopper member also serves as a holding member which holds a distal end side of the guide tube.

Abstract: A method of endoscopically approaching a duodenum includes: inserting an endoscope into a duodenum of a subject through stomach; inserting a venting device into the stomach; and deflating the stomach by removing air from the stomach through the venting device.

Abstract: Insertion equipment includes an insertion section, a distal end member provided at a distal end of the insertion section, and a tube configured to supply a fluid to the distal end member. In the distal end member, the fluid passes through a first flow channel extending in a distal end direction, passes through a second flow channel in a direction different from the distal end direction, is divided, is discharged through a first opening in a distal end surface, and part of the fluid is discharged through one or more second openings in an outer circumferential surface of the distal end member in a radial direction or a proximal end direction.

Abstract: In an imaging system, a camera unit and a control unit are connected via a source voltage line and an image signal line. The camera unit includes: a pixel array configured to generate an accumulation signal and a reset signal; a source voltage measuring circuit configured to output a voltage value (VDDA) indicating a second source voltage in the pixel array; a reference voltage generating circuit configured to generate a reference voltage (VBGR); a plurality of AD conversion devices; and a signal transmitting unit. The control unit includes: a source voltage supply device configured to supply a first source voltage (Vout) to the source voltage line; and a signal receiving device configured to receive the image signal and the result of the second AD conversion.

Abstract: An image processing device includes a processor. The processor is configured to: recognize blood vessel running information; recognize a first bleeding position from a surgery image; identify a second bleeding position in the blood vessel running information corresponding to the first bleeding position in the surgery image; and identify a bleeding stopping point corresponding to the second bleeding position as a bleeding stopping recommended point corresponding to the first bleeding position. The processor: acquires information about the bleeding stopping recommended point corresponding to each of one or more blood vessel areas in the blood vessel running information; identifies the blood vessel area among the one or more blood vessel areas, to which the second bleeding position belongs; and performs processing in which the bleeding stopping recommended point corresponding to the blood vessel area thus identified is superimposed on the surgery image and displayed on a display.

Abstract: A full-thickness resection method for a gastrointestinal tract includes forming a pair of first markings in surrounding tissue on both sides of a lesion to sandwich the lesion therebetween; performing a full-thickness resection to a portion including the lesion; identifying a pair of suture locations in the vicinity of the pair of first markings; and suturing the pair of first suture locations.

Abstract: A bending tube includes a first tubular member including a first tubular opening and a second tubular member including a second tubular opening. The first tubular member includes a first end portion, a first hole, and a projection on a surface of the first end portion around a periphery of a first end of the first hole. The second tubular member includes a second end portion, a second hole, and a turning shaft projecting from a periphery of a first end of the second hole. The first end portion overlaps the second end portion and the turning shaft is seated in the first hole to connect the first tubular member to the second tubular member. The projection on the surface of the first end portion contacts a surface of the second end portion.

Abstract: An imaging system includes a camera device and a control device connected to each other by a power source line, a video signal line, and a ground line. An image sensor of the camera device receives, as a distal end voltage, a power source voltage output from the control device to the power source line. An output circuit of the camera device outputs a digital signal indicating a value of the distal end voltage to the video signal line. A calculation circuit of the control device calculates a resistance value of the power source line based on a value of the power source voltage, the value of the distal end voltage indicated by the digital signal, a current value of the power source line, a resistance value of the ground line, and a current value of the ground line.

Abstract: An electronic component holding member includes a first base material including an electronic component, a first resin molded product, and first metal patterns in which a signal pattern and a grounding pattern are formed on a non-planar surface, a second base material including a second resin molded product, and a second metal pattern formed on a non-planar surface so as to overlap at least part of the first metal patterns, and grounding wiring configured to connect the grounding pattern and the second metal pattern.

Abstract: An image pickup unit includes: an image pickup substrate including a first principal surface and a second principal surface, a light receiving circuit being formed on the first principal surface and a through wiring being placed on an inner surface of a via hole including an opening in the second principal surface; a solder resist film placed around the via hole on the second principal surface and in the via hole in a range from a bottom face to a level not reaching the second principal surface; and a bonding terminal which is made of solder, covers a surface of the solder resist film placed in the via hole, and is bonded to the through wiring on an outer edge of the opening in the via hole, the through wiring being not covered with the solder resist film.

Abstract: An image pickup unit for endoscope includes a first barrel having first hardness, a second barrel having second hardness in which an optical member is internally provided, the second barrel being held in a hole of the first barrel to be movable, a film having third hardness formed on one of an inner surface of the hole and an outer surface of the second barrel, a magnet provided in the second barrel, and a coil provided in the first barrel and configured to generate a magnetic field that acts on the magnet. The second barrel has a magnet or is composed by a magnetic material. The second barrel slides in the first barrel according to energization to the coil. The third hardness is lower than the first hardness and the second hardness.

Abstract: An image pickup unit includes: an image pickup optical system including an optical axis; an image pickup device; a first electric substrate on which the image pickup device is mounted; a second electric substrate formed integrally with the first electric substrate and configured to surround peripheries of the image pickup optical system and the image pickup device and extend in a direction along the optical axis, the second electric substrate including a housing space for housing the image pickup optical system and the image pickup device, a part of the second electric substrate being formed in an arc shape when viewed in a cross section in a vertical direction with respect to the optical axis; and a conductive circuit connecting the first and second electric substrates, and provided from a first surface exposed outside of the second electric substrate to a second surface in the housing space.

Abstract: Provided is an image processing apparatus including a processor. The processor is configured to: reconstruct, by employing a plurality of time-series images acquired by an endoscope, three-dimensional information of an imaging subject containing relative dimensions; calculate, on the basis of focus information of each of the plurality of images, scale information for converting the relative dimensions of the three-dimensional information to absolute dimensions; convert, by employing the scale information, the relative dimensions to the absolute dimensions; and output three-dimensional information containing the absolute dimensions.

Abstract: An imaging unit includes: an illumination unit that includes an illumination optical system; a first holding frame configured to hold the illumination unit; an imaging-unit main body that includes an imager, and an observation optical system configured to form the subject image on the imager; and a second holding frame configured to hold the imaging-unit main body. A first abutting portion configured to abut on the second holding frame in a radial direction of the first holding frame is arranged on an outer surface of the first holding frame.

Abstract: An image pickup module includes: a lens unit including a first principal surface and a second principal surface; an image pickup unit including a third principal surface and a fourth principal surface on which an external electrode is disposed; a wiring board including a hole and a bonding electrode disposed on a bottom surface of the hole; a solder that bonds the bonding electrode and the external electrode; a rigid member that defines a spacing between the fourth principal surface and the bottom surface; and a second resin disposed between the fourth principal surface and the bottom surface.

Abstract: An endoscope reprocessor includes: a cleaning tank in which an endoscope is placed; an endoscope connecting unit configured to be connected to a channel of the endoscope; a top cover configured to cover an upper part of the cleaning tank; a first ejection unit configured to eject a cleaning solution toward an inner surface of the top cover; a first pump connected to the first ejection unit; and a control unit provided with a processor configured to feed a liquid to the channel of the endoscope by controlling the first pump, in which the processor acquires a type of the endoscope, controls the first pump during cleaning according to the type of the endoscope, and causes the cleaning solution to be delivered from the first ejection unit.

Abstract: An image pickup apparatus includes a lens unit and an image pickup unit. The lens unit includes a plurality of optical devices including a first optical device that includes: a first glass substrate having a first principal surface and a second principal surface and a groove leading to the second principal surface from the first principal surface in at least one of four corners on an outer edge; first resin disposed in the groove; and a resin lens disposed on the second principal surface. The image pickup unit including an image pickup device is disposed on an optical device not including the first resin, of the plurality of optical devices.

Abstract: A lens unit includes: a first optical device including a first glass substrate including a first principal surface and a second principal surface, and a resin lens disposed on the second principal surface; a second optical device including a second glass substrate including a third principal surface and a fourth principal surface, in which the third principal surface is disposed facing the second principal surface, and a substantially rectangular aperture layer made of metal that is disposed on the third principal surface and that has four corner regions cut out; and an adhesive layer that adhesively bonds the first optical device and the second optical device, in which four corner regions do not sandwich the aperture layer between the first optical device and the second optical device.

Abstract: A lens unit includes a first optical element including a first principal surface that is an incident surface; and including a first glass substrate and a first resin, the first glass substrate including a frame-shaped cutout at an outer edge of the first principal surface, the first resin being disposed only in the cutout.

Abstract: A method of manufacturing a lens unit includes: producing a stacked wafer including a plurality of optical wafers that include at least one optical wafer in which a light shielding layer is disposed and having a first principal surface and a second principal surface; forming grooves in a grid pattern on the first principal surface or the second principal surface of the stacked wafer using a dicing blade, in which the grooves have a depth at which the light shielding layer is cut; and dividing the stacked wafer into a plurality of lens units by performing stealth dicing using a filamentation laser along the grooves.

Abstract: A treatment tool generator includes: a power source configured to supply power to a treatment tool; and a processor configured to control an operation of the power source and the treatment tool, the processor being configured to cause the power source to supply the power to the treatment tool to apply treatment energy to a biological tissue from the treatment tool, calculate a thickness index value to be an index of a thickness dimension of the biological tissue that is grasped by the treatment tool, determine whether it is a change timing to change a control state of at least one of the power source and the treatment tool based on the thickness index value, and perform at least one of a first control, a second control, and a third control upon determining that it is the change timing.