Abstract: Lysing of fat cells in adipose tissue beneath the skin and liquefying the released fat is achieved by introducing a side-firing thermal energy device into the tissue to be irradiated, while thermal energy, such as laser energy, is emitted at a selected level for a selected period of time, depending on the volume to tissue to be irradiated. The side firing device is advanced into tissue and withdrawn and, while energy is emitted, is aimed separately at 3 o'clock and 9 o'clock and, is repetitively rotated through an arc of about 120°, producing a bowtie-shaped irradiation pattern. The side firing device may be centered and sealingly held in position in a liposuction cannula by ribs extending inwardly from the interior of the liposuction cannula. At least one of the ribs has a channel for infusion of an irrigating liquid.

Abstract: Improved laser energy delivery devices, providing greater transmission efficiency, longevity of use and safety are described. In one embodiment, a device for delivering laser energy includes a conventional optical fiber within a metal or plastic cannula provided with a laser energy emission window. A reflective material is disposed in a space between the distal end portion of a metal or plastic sheath and the optical fiber, as well as about any extension or endpiece of the distal end of the sheath. The reflective material reflects aberrant emissions of laser energy from the optical fiber as it erodes, and laser energy backscattered from the target tissue away from the distal end of the sheath back into the optical fiber or out of the distal end of the sheath, thereby preventing damage due to overheating. Other embodiments include devices that transmit laser energy more safely, efficiently and durably laterally from the axis of the optical fiber.

Abstract: A laser energy delivery device is provided that is suitable for irradiating a body tissue with relatively long wavelength laser energy in the presence of an aqueous liquid without significant absorption of the laser energy by the liquid. The device includes an elongate hollow sheath that has an open aperture at its distal end portion and closed at its proximal end, a laser energy conduit such as an optical fiber or hollow wave guide, within the sheath, the distal end of the conduit being disposed near the open aperture at the distal end portion of the sheath, and the proximal end of the conduit being adapted for connection to a source of long wavelength laser energy. The sheath also includes an inlet port, spaced from the proximal end of the sheath, and adapted to receive and deliver a biologically compatible gas through the sheath to a body tissue site in contact with the open distal end of the sheath.

Abstract: The invention relates to a catheter device including an optical fiber whose distal end is disposed within a hollow tube with a sharp or needle shaped distal end, which can penetrate tissue. The distal end of the optical fiber and the hollow tube are configured so as to emit, by refraction (total internal reflection) or reflection from a metal surface, laser energy at an angle of about 80° to about 90° relative to the longitudinal axis of the optical fiber and hollow tube. The hollow tube is mounted to a housing and may be surrounded by a sheath.

Abstract: A method and devices for generating laser pulse trains for delivery to a target including the use of a single laser generator which produces a plurality of pulse groupings of two or more individual laser pulses within each laser pulse train, generated at selected time intervals. The time intervals between the individual pulses within each of the pulse groupings along with the intervals between pulse groupings themselves are selected and controlled by a controller in reference to several variables including the emission and energy storage lifetimes of the lasing medium, the thermal diffusion time constant of the target, the time required to cool the target after the application of laser pulses to its ambient temperature, and the dissipation time of acoustic waves generated by the pulses.

Abstract: A laser energy delivery device and method are provided for irradiating a body tissue with relatively long wavelength laser energy in the presence of an aqueous liquid without significant absorption of the laser energy by the liquid. The device includes an elongate hollow sheath that is open at its distal end and closed at its proximal end, a laser energy conduit such as an optical fiber or hollow waveguide, within the sheath, the distal end of the conduit being disposed near the open distal end of the sheath, and the proximal end of the conduit being adapted for connection to a source of long wavelength laser energy. The sheath also includes an inlet port, spaced from the proximal end of the sheath, and adapted to receive and deliver a biologically compatible gas through the sheath to a body tissue site in contact with the open distal end of the sheath.

Abstract: An optical fiber device for ablating a channel through a plaque deposit or a clot in a blood vessel is described. Laser energy is transmitted through one or a bundle of optical fibers to a quartz or fused silica cylinder, whose distal end surface has been made into a desired shape and sandblasted or carbon coated or both. The cylinder is received with a pocket defined in a sheath which surrounds the optical fibers. Moreover, the cylinder includes a circumferential recess and the sheath includes a circumferential rib which engages into the recess for securing the lens in the pocket. In one embodiment, the cylinder has a cavity formed therein and the distal end of the optical fiber extends into the cavity. In a further embodiment, the device is adapted to be guided along a wire extending through the pocket and an aperture defined in the sheath and/or a channel defined in the cylinder.

Abstract: The invention relates to a catheter device including an optical fiber whose distal end is disposed within a hollow tube with a sharp or syringe shaped distal end, which may be inserted into tissue. The distal end of the optical fiber and the hollow tube are configured so as to emit, by refraction (total internal reflection) or reflection from a metal surface, laser energy at an angle of about 80° to about 90° relative to the longitudinal axis of the optical fiber and hollow tube. A first fluid channel within the distal end portion of the tube enables fluid to be infused to cool the distal end of the tube and to cool and clean the emission face of the optical fiber. A second, relatively larger diameter fluid channel in the tube enables the fluid, flowing through said first channel along with hot gasses from the vaporization of tissue, to exit the device through a second port in the tube, away from the tissue being treated.

Abstract: A catheter device suitable for shrinking chordae tendineae of the human heart is provided having an energy conduit and a positioning device that facilitates the delivery of thermal energy, including coherent (laser) or non-coherent light, RF, microwave or ultrasound energy, to a predetermined region of the chordae tendineae or other collagen-containing tissue, such as the female urethra or the esophagus near the sphincter. The device comprises a tubular catheter containing an energy conduit, such as a fiber optic cable, adapted for delivering thermal energy to the tissue. The tubular catheter also contain a stabilizing device, disposed at its distal end, such as an asymmetrically shaped balloon or a retractable flexible metal hook. With the distal end of the catheter device positioned within a human heart, application of thermal energy to the chordae tendineae results in a shrinkage of the chordae, providing a treatment for primary mitral valve regurgitation.

Abstract: Particles larger than 7 microns in diameter and containing a therapeutic material are described. Such particles are sufficiently large to lodge in tissue or a blood vessel and can be made to rapidly degrade therein before creating infarcts. Rapid degradation of liposomes containing a therapeutic agent can be achieved by either preparing the liposome in a high salt solution or incorporating in the liposome a component which is stable at or below room temperature, but which becomes unstable at 35° C. or higher. Such particles are useful in delivering, for example, angiogenic growth factors or genes coding for angiogenic growth factors into the coronary arteries of the heart or the heart muscle, as well as other therapeutic agents into organs or tissues or blood vessels feeding the same to achieve a desired effect.

Abstract: Light energy is utilized to shrink or tighten tissue surrounding a hollow organ, cavity, duct or naturally occurring or surgically created passage by cross-linking the collagen of the surrounding tissue and ccausing scar formation therein. The present device may be used in the esophagus in the area of the sphincter to treat GERD, in the female urethra to treat FSI or at the vesicouretal junction to treat VUR. In the present device, a plurality of plastic tubes, each containing a slidable optical fiber with a sharpened distal end, are affixed to the outer surface of a balloon, which is mounted near the distal end of a closed end catheter. The balloon catheter may be inserted into the body inside a retractable protective sheath. When the sheath is retracted, exposing the balloon, the balloon is inflated, which presses the distal ends of the plastic tubes against the surrounding tissue.

Abstract: A lasing device for performing a myringotomy or like procedure is provided. The distal end portion of an optical fiber used to transmit a laser energy beam to the surgical site is covered with a disposable, removably mounted sheath, whose distal end is substantially transparent to the wavelength of laser energy being emitted through the optical fiber. Optionally, a relatively low power aiming beam can be emitted coaxially with the laser energy beam.

Abstract: Stem cells, bone marrow or bone marrow enriched with stem cell compositions suitable for tissue repair are disclosed. Such compositions can be introduced into a host's tissue deficient in blood flow or deficient in a cell type, preferably by creating a trap or pocket within the tissue for confining injected material. The trap or pocket can be created using mechanical and light energy, or like expedients.

Abstract: A variable pulse width lasing device for selectively reducing the amount of laser energy provided during a surgical procedure is described. The device includes a central processing unit, a laser resonator, pulse width detector and a pulse modulator. The central processing unit provides a switch activation command to the modulator. The modulator also receives a laser pulse produced by the laser resonator which has an initial pulse width and a wavelength which is compatible for transmission through an optical fiber. The modulator varies the width of the laser pulse for providing an output pulse at a selected pulse width and energy level.

Abstract: This invention is a device (10) for releasing a therapeutic appliance, such as an embolic coil (12) inside an aneurysm (16). The device includes a coupling (24) of a shape memory alloy which is responsive to a change in temperature beyond a predetermined transformation point so as to change the shape of the coupling from a first configuration, wherein the coupling receives and holds the proximal end (72) of the coil, to a second configuration wherein the coil can be released from the coupling. An energy receiver (46) is operably associated with the coupling to heat the coupling to a temperature above the transformation point with laser or electrical energy received from an external source.

Abstract: A method of percutaneous and subcutaneous laser treatment of the tissue of a patient is provided. The tip of an optical fiber is be passed through the skin, advanced through the tissue subcutaneously to a desired treatment area and withdrawn. Laser energy can be emitted at different levels during any or all of the skin penetration, advancement, tissue treatment and withdrawal phases. The present invention is useful for surgical treatments, and is especially suitable for minimally invasive plastic or cosmetic surgical and dermatological procedures without bleeding and with less edema, erythema and swelling and faster healing than conventional surface laser energy application, abrasion, scalpel surgery or chemical peel procedures.

Abstract: A split-flow laser cooling assembly for providing separate cooling environments for the pumping medium and the laser medium. The device includes a generally transparent monoblock, a pumping medium for providing pump light, and a laser medium responsive to the pump light for generating laser energy. The monoblock is generally transparent and has a first open bore and a second open bore oriented with axis' parallel to each other. The first bore receives the pumping medium such that a pump cooling passage is provided between the monoblock and the pumping medium. Likewise, the second bore receives the laser medium such that a laser cooling passage is provided between the laser medium and the monoblock.

Abstract: An attachable enclosure for a lateral lasing device comprising a fiber optic for emitting a laser beam and an exposed reflector for laterally reflecting the laser beam opposite the distal end of the fiber optic. The enclosure comprises an elongated body having a head portion with an open end and a tail portion. The elongated body defines a longitudinal flute for receiving and immobilizing the mounting stem of the lateral lasing device within its body. The hollow envelope has an open end and a fluid exit port, and is removably mounted to the head portion of the elongated body at its open end. The hollow envelope is dimensioned to surround the laser beam reflector and is in fluid flow communication with the longitudinal flute through the open end of the hollow envelope.

Abstract: A surgical laser instrument including a transparent, splay, plate-like waveguide including one or more discontinuities therewithin for flattening and expanding a laser beam received through the waveguide and for emitting therefrom a relatively flat laser beam that can be utilized to sweep a selected tissue or region to be treated.

Abstract: A medical device applies localized heat to a site in a patient's body by irradiation with light and by conduction. The device includes a radiant energy transmitting conduit, typically an optic fiber, that carries radiant energy, typically high intensity light such as laser, into a body cavity, typically the uterus, from an energy source, typically a laser source, that is located exterior to the body. At the operative head of the device within the body cavity a portion of the transmitted radiant energy is absorbed and converted to heat. This heat is radiated or conducted from the device head substantially omnidirectionally in order to aid in destruction of tissue, Meanwhile, another portion of the transmitted radiant energy is emitted through an aperture in the device head as light energy suitable for more localized and intense heating and destruction of tissue or other organic matter. This light emission is preferably directionally transverse to an elongate body of the device head.