Abstract: A manual and automatic fluid control system and method for use in open and laparoscopic laser surgery and electrosurgery is disclosed. The system includes a manual mode along with several automatic modes which can effectuate both suction and irrigation, either individually or simultaneously. In the various automatic modes, the suction and/or irrigation is automatically activated during activation of a medical apparatus for laser surgery or electrosurgery without requiring separate activation from the surgeon or operating room staff. Several safety features for monitoring the fluid control system are also incorporated within the system such as fluid sensors for detecting the absence of irrigation fluid, pressure sensors and vacuum systems for monitoring fluid pressure, fluid sensors for monitoring fluid volume, and warning signals for detecting empty containers.

Abstract: A laser probe including an optical fiber for guiding a laser beam, a holder fixed at an end portion of the optical fiber, and a reflection tip detachably attached to the holder and having a reflection surface for reflecting the laser beam emitted from the optical fiber.

Abstract: An apparatus for removing brain tumors by vaporizing the tumor tissue with a laser beam in select scan planes of the tumor. A cored hole through the tumor is made by the laser beam, and an endoscope is inserted through the cored hole, which has a mirror mounted at a 45 degree angle near the end of it and mounted within it, that is capable of reflecting the laser beam at a 90 degree angle. The endoscope is inserted all the way through the cored hole, and sucessive scans of the brain tumor are taken perpendicular to the endoscope. The endoscope is then moved axially to position the 45 degree mirror at each scan plane, and the reflected laser beam is then rotated and also oscillated between calculated angles to vaporize the tumor tissue in each scan plane, until the entire brain tumor is vaporized by the laser beam. During this procedure the gas being produced by vaporization of the tumor tissue is suctioned out through the interior of the endoscope.

Abstract: A method for the photodisruption of tissue using a laser beam for stereotactic laser neurosurgery includes the initial step of positioning the distal end of a probe into the tissue to be photodisrupted. A laser beam having laser pulses of picosecond or femtosecond duration is then directed along a beam path through the probe. Using a focusing lens, which is slidably positioned on the beam path in the probe, and a light reflector, which is slidably positioned on the beam path at the distal end of the probe, the laser beam is focused to a focal point that is located on a line substantially perpendicular to the beam path through the probe. By concerted movement of the lens and mirror, predetermined cylindrical layers of tissue can be photodisrupted. Specifically, a rotation of the mirror causes photodisruption of tissue along a circular arc and a simultaneous movement of the lens and mirror allows for photodisruption of additional arcs on a cylindrical surface.

Abstract: An obturator for measuring incident light in a remote situs such as a body cavity which includes a treatment tubular member through which light is delivered to the remote situs and one or more auxiliary tubular members through which incident light in the remote situs is transmitted to an external light detector. The treatment and auxiliary tubular members are attached to a connector element which is in turn connected to a cystoscope lens port. The treatment and auxiliary tubular members are aligned off-center with respect to the central axis of the obturator so that a cystoscope lens can be inserted in the lens port and pass through the axial center of the obturator. Each auxiliary tubular member receives incident light from a different portion of the remote situs. The apparatus is particularly useful for conducting phototherapy in body cavities and has been demonstrated in the phototherapy treatment of superficial cancer in the bladder.

Abstract: A multiple tool laparoscopic surgical instrument that includes a hand piece, an outer conduit connected to the hand piece, four inner conduits within the outer conduit, an interior channel within the outer conduit, a hypodermic needle housed at least partially within a first one of the inner conduits, an electrocautery cutting tool housed at least partially within a second one of the inner conduit, and a needle electrode housed at least partially within a third one of the inner conduits. In operation, the interior channel of the outer conduit, which is connected to an external source of irrigating fluid and a suction device, is used to provide gentle irrigation as well as suction. A fourth one of the inner conduits, which preferably has a cross sectional area smaller than that of the interior channel of the outer conduit, is also connected to an external source of irrigating fluid to provide more vigorous irrigation.

Abstract: An apparatus for delivering laser energy to a target through a radiation-transmitting waveguide having a distal end terminating in a tip which is in contact with the target during delivery, while protecting the tip from heat damage, which apparatus comprises a waveguide for transmitting laser radiation and having a distal end terminating in a tip adapted to be placed in contact with the target to deliver laser energy directly to the target at the site of contact, and means for delivering a controlled small amount of liquid to the target adjacent to the tip, which small amount is just sufficient to limit the temperature at the target to not more than the failure temperature of the tip. An apparatus assembly for performing ILC incorporating a waveguide and a method for protecting the tip of a waveguide from damage is also disclosed.

Abstract: An endoscope has an elongated flexible guide the distal end of which can be introduced into a selected chamber of a human or other animal heart or into the internal space of another body organ. The tube confines a major portion of an elongated flexible sheath the distal end of which carries an inflatable balloon for the distal end portions of elongated flexible optical conductors some of which serve to illuminate selected portions of a surface bounding an internal space. The remaining conductors serve to transmit images of the illuminated portions of the surface toward the proximal end of the tube. When inflated, the ballon shields the distal ends of the conductors from contact with the body fluid in the internal space. A three-dimensional frame is provided to maintain the inflated balloon in any one of a number of different positions in a body cavity.

Abstract: A method of treating a patient's prostate. An endoscopic instrument is inserted through the patient's urethra such that a distal portion of the endoscopic instrument is inserted into the patient's prostatic urethra and engaged with an interior wall of the prostatic urethra. A laterally transmitting laser fiber tip of a laser fiber is placed in the endoscopic instrument adjacent to a window therein such that the tip is spaced laterally from an area of the interior wall of the prostatic urethra. Laser light energy is transmitted laterally from the tip through the window onto the interior wall for treatment thereof. A telescope may be placed adjacent the laser fiber tip so that the interior wall of the prostatic urethra may be viewed. Irrigating fluid may be provided from a source external of the patient through the endoscopic instrument to a proximity of the tip. Excess fluid may be returned through the instrument to a fluid dump zone external of the patient's body.

Abstract: A device and method are provided for evaluating and relieving the symptoms associated with joint disorders. The cannula device has two channels extending from the proximal end to the distal end. The first is used to retain an arthroscope; the second, an optical fiber for transmitting laser radiation. In a particular embodiment, the device may be used for performing surgical procedures within a temporomandibular joint space including, but not limited to, releases, myotomies, and coagulation. This arrangement permits the collocation of the visualizing and surgical implements, obviating the need for triangulation by the surgeon. A third channel is provided for the introduction of irrigating fluid into the joint space. The method disclosed includes inserting the cannula into the joint space, inserting the arthroscope and fiber into their respective channels, and positioning them to perform the desired procedure.

Abstract: A liquid core laser optical scope for illuminating, viewing, and delivering laser energy to a site in a lumen of an animal or human body which includes a flexible tube for insertion into the lumen, a conduit housed within the tube, a fluid source for coupling a flow of light transmissive liquid into the conduit, a light source for transmitting visible light through the tube to illuminate the site, an optical fiber bundle having an optical receiving end disposed at the distal end of the optical scope for imaging the illuminated site and transmitting a visible image thereof through the optical scope to an external viewing port, and a fluid core light guide for transmitting laser energy from an energy source into the conduit where the conduit has a sidewall capable of internally reflecting light into the liquid in the conduit so that the liquid waveguides the laser energy through the conduit to the site.

Abstract: A system for delivering a probe into a body part to perform a therapeutic or diagnostic procedure therein which includes an elongated probe device which is disposed within a protective sheath and which has a rotary drive unit connected to its proximal extremity to rotate the probe about its longitudinal axis, preferably at a rate above 50 rpms while applying axial pressure thereto to cause the distal end of the probe to penetrate through the patient's tissue to a desired location in the body part where the procedure is to occur. In a presently preferred embodiment, the probe is an optical fiber which is delivered into a male patient's prostate gland through the patient's prostatic urethral wall. The optical fiber is optically connected to a source for laser energy (815 nm) which is emitted from the distal end of the optical fiber to ablate prostatic tissue surrounding the distal end.

Abstract: A shapeable optical fiber apparatus includes an optical fiber, a support structure secured over a distal end portion of the optical fiber, and terminates in a lens at its distal end. The transition area between the lens and optical fiber is reinforced with a sleeve that is adhesively bonded to the lens and fiber. The shapeable optical fiber apparatus may be carried within an inflatable balloon dilation catheter, which may be used for balloon angioplasty after a laser cutting procedure using the shapeable optical fiber apparatus to remove a portion of stenosis in the patient's vasculature.

Abstract: An endoscopic instrument having a diode laser at the distal end of the instrument for cutting and/or coagulating tissue during an endoscopic procedure.