Abstract: An optical fiber includes an integrated detector in the form of phosphors that emit light of a characteristic frequency or wavelength in response to leakage, through the fiber cladding, of light having an interrogation wavelength ?1. Stimulation of phosphor emission by the interrogation light is indicative of aging or wear on the layers surrounding the cladding, and therefore can be used to assess the risk of imminent breakage of the fiber.

Abstract: An apparatus for delivering energy, and in particular laser energy, to a tissue includes a protective quartz cap that is secured to a laser delivery fiber by a crimp sleeve. The fiber may have a conical tip, and the quartz cap may be secured to the crimp sleeve by a layer of epoxy.

Abstract: A handheld controller for laser surgical applications includes a variable time delay control to allow a surgeon to delay interruption of laser firing in response to feedback from an overheating detector, and a detector sensitivity control for changing a sensitivity of the detector.

Abstract: A method and apparatus for improving the safety of a surgical procedure involving delivery of laser energy to a tissue, involves enhancing or increasing the detectability of radiation emitted by the tissue or any portion of a surgical instrument or device by providing a sacrificial material that absorbs radiation emitted during the surgical procedure, increasing the temperature of a surface on which the material is disposed and/or causing damage radiation to be emitted in a way that can be detected by monitoring the temperature of the surface and/or radiation, including infrared and/or visible light, emitted by the surface. In a preferred embodiment of the invention, the radiation absorbing material is a sheath arranged to surround the fiber.

Abstract: A medical laser safety feedback apparatus and method enhances the detectability of a feedback signal from the treatment site by modulating or encoding an aiming or reference beam that is used to provide a stimulated emission or reflected component of the feedback signal.

Abstract: A protective sheath of the type used to protect a scope during insertion of a fiber into the scope includes marks on an outer diameter that enable positioning of the sheath relative to a scope with the need for a locking connector. The sheath can be held in the correct position by a physician's choice of leakage prevention device. A simplified miniature connector may be used to hold the fiber in position relative to the sheath.

Abstract: A method for positioning a surgical laser fiber to facilitate delivery of therapeutic light to a tissue utilizes a flexible insertion sleeve to protect a scope as the fiber and sleeve are guided to a treatment site past bends in the scope. The fiber and sleeve are fixed relative to the scope by a fiber lock. The sleeve may include holes and/or other optional features to protect the fiber or scope during insertion and treatment.

Abstract: A protective sheath of the type used to protect a scope during insertion of a fiber into the scope may include holes for improved fluid flow and for ease of sterilization, reinforcement, a luer connector to position the sheath relative to a scope and to enable use of a seal, pin vise or other device to secure the fiber to sheath during insertion or withdrawal of the sheath from the scope, and/or markings to facilitate positioning of the sheath relative to the scope and/or trimming of the fiber.

Abstract: A fiber optic connector for coupling focused radiant energy from a laser to a fiber optic conductor includes a quartz alignment ferrule that is fused mechanically and optically to the fiber's proximal end, either by an index matching first adhesive or by heat fusing the cladding to the ferrule without removing the cladding from the end of the fiber. The fiber and ferrule are attached to the fiber's proximal termination connector by a second adhesive with a high refractive index which absorbs errant radiant energy that has propagated in the fiber's cladding. The absorbed errant energy is dissipated by the connector assembly as it is converted to heat.

Abstract: Methods and arrangements for distinguishing between target areas and non-target areas during a laser surgical procedure involve coating or otherwise providing the non-target areas with a phosphorescent material that emits radiation, upon stimulation when a predetermined condition occurs, that is distinguishable from the treatment radiation.

Abstract: Failure events detected by a laser surgery monitoring feedback circuit are analyzed in order to distinguish between events that result from fiber breakdown and those arising from other sources, such as burning of tissues. If the number of failure events within a predetermined time exceeds a predetermined count, then it is determined that the radiation is the result of fiber breakdown. If the number of failure events within the predetermined time is less than the predetermined count, then it is determined that the failure events result from other causes, such as heating of tissues by the laser. Based on the analysis, an override switch or alarm may be initiated.

Abstract: An end-firing optical fiber includes protective ferrule through which treatment radiation is fired in an axial direction, the protective ferrule having refractive properties that cause the radiation to disperse laterally and/or the fiber having sufficient flexibility to enable the fiber to be aimed at a tissue situated to the side of the axis along which the fiber was inserted. The fiber and protective ferrule may be mounted in a cannula, with the cannula being sufficiently flexible to enable the cannula to be withdrawn into a scope having a straight working channel, but has a pre-formed curvature that enables treatment of lateral tissues when the cannula is extended out of a scope.

Abstract: A protective sheath is provided to prevent mechanical damage to the working channel of the endoscope during insertion of the fiber, insulate the fiber from surrounding cooling fluids, and/or serve as an indicator of overheating that enables early detection of excess heating or burning of tissues or equipment at the treatment site. The protective sheath may include trim markings to facilitate cutting to a desired length, such as the length of the fiber in the scope, may also be arranged to glow when the fiber is pulled too far into the sheath, may be tightly fitted over the fiber to provide a plunger effect, and may include perforations to facilitate sterilization.

Abstract: Failure events detected by a laser surgery monitoring feedback circuit are analyzed in order to distinguish between events that result from fiber breakdown and those arising from other sources, such as burning of tissues. If the number of failure events within a predetermined time exceeds a predetermined count, then it is determined that the radiation is the result of fiber breakdown. If the number of failure events within the predetermined time is less than the predetermined count, then it is determined that the failure events result from other causes, such as heating of tissues by the laser. Based on the analysis, an override switch or alarm may be initiated.

Abstract: A handheld controller for laser surgical applications includes a variable time delay control to allow a surgeon to delay interruption of laser firing in response to feedback from an overheating detector, and a detector sensitivity control for changing a sensitivity of the detector.

Abstract: A method and apparatus for improving the safety of a surgical procedure involving delivery of laser energy to a tissue, involves enhancing or increasing the detectability of radiation emitted by the tissue or any portion of a surgical instrument or device by providing a sacrificial material that absorbs radiation emitted during the surgical procedure, increasing the temperature of a surface on which the material is disposed and/or causing damage radiation to be emitted in a way that can be detected by monitoring the temperature of the surface and/or radiation, including infrared and/or visible light, emitted by the surface. In a preferred embodiment of the invention, the radiation absorbing material is a sheath arranged to surround the fiber.

Abstract: The shape of a surgical instrument is changed during a surgical procedure by using a laser to heat a shape memory alloy or other shape memory material in the surgical instrument, thereby causing the instrument to assume a predetermined shape, while at the same time monitoring the heating site to prevent overheating.

Abstract: An apparatus for delivering energy, and in particular laser energy, to a tissue is adapted to minimize or eliminate burn back caused by contact between the energy delivery apparatus and bodily fluids by (I) preventing the energy delivery apparatus from contacting bodily fluids or tissues that might burn or cause the apparatus to burn; and/or (ii) monitoring the apparatus to detect overheating in order to withdraw the apparatus or control the energy supply in case overheating is detected. The apparatus is applicable, by way of example, to treatment of blood vessels using endovascular techniques.

Abstract: An apparatus for delivering energy, and in particular laser energy, to a tissue includes a protective quartz cap that is secured to a laser delivery fiber by a crimp sleeve. The fiber may have a conical tip, and the quartz cap may be secured to the crimp sleeve by a layer of epoxy.

Abstract: A temperature of a laser treatment area is monitored and an output of a laser is controlled or modulated to prevent damage resulting from thermal runaway or burn back. The detector may be positioned proximate or at a distal end of the fiber, and may be in the form of a detector arranged to detect leakage of higher order propagation modes from a bend in the fiber. Manual or automatic cleaning of the fiber may be initiated upon detection of overheating, either by dipping the fiber in a cleaning solution or supplying cleaning fluid to the fiber or treatment area. A fiber position detector may also be included to prevent damage when the fiber is withdrawn into an introducer or catheter.