Abstract: Systems, devices, and methods for delivering laser energy directed toward target tissue using a spectroscopic feedback. An exemplary laser feedback control system comprises a feedback analyzer to receive a signal from a target tissue using a spectroscopic sensor, and a laser controller to determine whether the received signal generally equals a first preset. If the received signal meets the first preset, the laser controller can send a control signal to a laser system to change from a first state to a second state of the first laser system. The laser system can deliver laser energy via an optical fiber towards the target tissue.

Abstract: Disclosed are a sonotrode and its use for transdermal delivery of therapeutic or cosmetic compounds. The sonotrode 10 comprises a tubular neck 14 attached at a proximal end to a solid head 12 and ending at a distal end in a flared foot 16. When coupled to an ultrasonic transducer and applied to skin of a human or animal, the sonotrode enhances the delivery of compounds into the skin.

Abstract: Devices to perform femtolaser ablation and phacoemulsification are physically and/or operationally combined. In some embodiments the femtolaser ablation and phacoemulsification are housed together, and in other embodiments they are housed separately, but operated through a common display screen. At least some software can be shared by the femtolaser ablation and phacoemulsification functionalities. A non-transitory computer-readable memory can provide data that can be used to operate each of at least one femtolaser ablation functionality and at least one phacoemulsification functionality.

Abstract: A stiffening device is disclosed that is adapted to cooperate with a flexible kidney stone extractor. The stiffening device includes a tube having a lumen sized to receive a part of flexible kidney stone extractor; a diversion member having a channel that is configured to receive a part of the flexible kidney stone extractor; and a connector coupled between the tube and the diversion member. The connector allows the channel of the diversion member to communicate with the lumen of the tube. A proximal portion of the connector is connected to the diversion member and a distal portion of the connector is connected to the tube.

Abstract: Primarily described are gel-forming systems, consisting of or comprising a composition (A), comprising one or several cationically crosslinkable polymer(s), and a composition (B), comprising one or several crosslinking agent(s) for crosslinking the cationically crosslinkable polymer(s) for use in a method for removing urinary calculi and/or fragments thereof, more particularly kidney stones and/or fragments thereof, from a region of the urinary tract, more particularly a kidney, that contains urinary calculi and/or fragments thereof, more particularly kidney stones and/or fragments thereof, that are to be removed, with the following steps: (i) providing the compositions (A) and (B), (ii) introducing the compositions (A) and (B) into a region of the urinary tract, more particularly the kidney, that contains urinary calculi and/or fragments thereof, more particularly kidney stones and/or fragments thereof, that are to be removed, under conditions enabling crosslinking of the cationically crosslinkable polymer(s

Abstract: A system may include a stone analyzer, a controller, a laser generator, and a beam combiner. The stone analyzer may be configured to generate an output relating to a natural or resonance frequency of a kidney or bladder stone. The controller may be configured to determine the natural or resonance frequency of the stone based on the output from the stone analyzer, and match a resultant pulse repetition rate with the natural or resonance frequency. The laser generator may be configured to generate at least two laser pulse trains, with each laser pulse train including laser pulses at a pulse repetition rate. The beam combiner may be configured to combine the at least two laser pulse trains into a combined laser pulse train including laser pulses at the resultant pulse repetition rate.

Abstract: Provided is a surgical handpiece for providing an electromagnetic cutting blade. The handpiece, comprises a body portion having an input end and an output end, a plurality of optical fibers for receiving laser energy having a wavelength within a predetermined wavelength range, wherein the optical fibers are received in the body portion at the input end and extend to the output end, and an optical fiber transition region within the body portion for arranging the plurality of optical fibers into a predetermine cutting shape at the output end, wherein laser energy transmitted from the arranged optical fibers at the output end interact with water molecules near the surgical target to generate micro-explosions that result in a cutting effect.

Abstract: A method of treating a condition associate with accumulation of an agent in cells in a patient includes exposing the cells to ultrasound, to selectively kill or induce apoptosis in the cells. The cells include the accumulated agent.

Abstract: Method for generating a shaped laser pulse in a lithotripter characterized in that if the pulse duration is divided into four intervals of equal length, less than 25% of the energy of the pulse is emitted in the first of those intervals, and in that the maximum intensity of the pulse is first reached in the second, third or fourth time interval, and wherein the intensity reached after the start of the third and/or forth interval is at least once the same as or higher than the maximum intensity reached in the second interval.

Abstract: A medical device and method for breaking a concretion in a body into smaller pieces and removing the pieces from the body are described. The device comprises a dilator sheath, a lithotripsy probe, a tubular member, and a retrieval basket. The dilator sheath adapted to penetrate into a passage of the body to reach the location where the concretion is located. The lithotripsy probe is configured for shattering the concretion into smaller pieces. The tubular member is mounted within the dilator sheath adapted to permit the lithotripsy probe to be inserted into the tubular member. The retrieval basket is coupled to the tubular member, and configured for entrapping the concretion and the smaller pieces for their extraction from the body.

Abstract: An improved method and device for safe and efficient medical applications is provided. In a preferred embodiment, based on using the inherent benefits of laser diodes (such as efficient power generation from a reliable and compact solid state device), plasmas and high energy vapors are produced for medical applications with power levels and power densities sufficient to treat medical indications and avoid the creation of extensive damage zones. Transmissions means in different configurations are used to achieve a high power density, which is able to initiate plasma and high-energy vapor at the tip. Once a sparkless plasma and high energy vapor bubbles are formed, it is often found that it will also absorb other wavelengths in addition to the one that initiated it. As a consequence, other wavelengths more efficiently generated by diodes or diode pumped lasers may be added into the beam in order to improve treatment efficiency.

Abstract: A method of ablating a solid substance within a mammalian body is presented. The method includes generating a superheated zone within the body using a fiber lasing assembly that emits pulses at a pulse repetition rate of 1 kHz to 500 kHz, where each pulse has a wavelength from 1.7 micron to 2.2 micron, a pulse width from 2 ns to 800 ns, and a pulse energy from 0.05 mJ to 2 mJ. The fiber lasing assembly used further includes a seed laser and an amplifier optically connected to the seed laser by an Ho-doped, Tm-doped, or Ho Tm co-doped fiber.

Abstract: A kit for surgically removing stones comprising: a double barreled sheath including a first barrel and a second barrel joined side-by-side; a first connector which is engaged at the proximal end of the first barrel; a second connector which is engaged at the proximal end of the second barrel; a first rigid tube interconnecting the first barrel with the first connector with the first connector being releasably engaged to the first rigid tube and the first rigid tube, first barrel and first connector being co-axial; a second rigid tube interconnecting the second barrel with the second connector with the second connector being releasably engaged to the second rigid tube and the second rigid tube, second barrel and second connector being co-axial; and a wire basket retriever adapted for insertion into one of the barrels and being releasably engaged with a connector or an actuation device.

Abstract: A medical device may include an elongate member having a proximal end, a distal end, and a lumen extending therebetween, wherein the elongate member may be configured for insertion into a patient. The medical device may also include a detection member configured to detect at least one of a location, geometry, or distance of a target relative to the distal end of the elongate member, the target being at least one of a stone, a foreign object, or a tissue within a body cavity. The detection member may include a transmitting element and a receiving element.

Abstract: A system includes at least one device that includes at least one device component. For a defined movement of the at least one device component, a movement axis and/or a movement direction may be selected by a selection element and may be identified by an activatable lighting element. The identified movement axis and/or the identified movement direction may be released by at least one actuation element, so that a desired movement of the at least one device component may be performed.

Abstract: Medical devices, methods and kits useful in the disruption and removal of unwanted materials, such as calculi and other formations, from within body lumens are described. The disclosure describes particular embodiments and methods useful in the lithotriptic removal of stones from the salivary glands.

Abstract: Various medical devices and methods are described herein. For example, various detachable control handle configurations for inclusion with a medical device are described. In another example, various probe configurations are described herein. Furthermore, various methods of treatment using a control handle are described.

Abstract: A kit for surgically removing stones comprising: a double barreled sheath including a first barrel and a second barrel joined side-by-side; a first connector which is engaged at the proximal end of the first barrel; a second connector which is engaged at the proximal end of the second barrel; a first rigid tube interconnecting the first barrel with the first connector with the first connector being releasably engaged to the first rigid tube and the first rigid tube, first barrel and first connector being co-axial; a second rigid tube interconnecting the second barrel with the second connector with the second connector being releasably engaged to the second rigid tube and the second rigid tube, second barrel and second connector being co-axial; and a wire basket retriever adapted for insertion into one the barrel and being releasably engaged with a connector or an actuation device.

Abstract: A system/method for destruction/ablation of stones, calculi or other hard substances using laser is disclosed. Lithotripsy is particularly benefitted. The system comprises a diode laser source, one or more optical fibers and a liquid delivery system creating a liquid environment around stones (calculi). At least one emitted wavelength is highly absorbed in surrounding/covering medium, causing evaporation and cavitation effects that lead to stone/calculi destruction. Different radiation configurations may be used. in one embodiment continuous radiation is used to create sparkler-less plasma bubbles to destroy hard substances. In another embodiment high peak power pulsed radiation is used. Wavelengths of 1470 nm, 1940 nm, or 1550 nm are preferred. Additionally device/method is used with another wavelength having absorption in water e.g. 980 nm. Safer/improved methods/system provide enhanced lithotripsy treatments with shorter treatment times to destroy a wider range of stones with less tissue damage risk.

Abstract: One aspect of the present invention relates to a method of using peristalsis to force a polymer plug through a mammalian lumen, thereby removing any calculi and/or calculi fragments present in the lumen. In one embodiment, the method is used as an alternative to conventional lithotripsy. In another embodiment, the method is used in conjunction with lithotripsy, thereby removing the small calculi fragments that result from such procedures.

Abstract: A medical device and method for breaking a concretion in a body into smaller pieces and removing the pieces from the body are described. The device has a dilator sheath, a lithotripsy probe, a tubular member, and a retrieval basket. The dilator sheath adapted to penetrate into a passage of the body to reach the location where the concretion is located. The lithotripsy probe is configured for shattering the concretion into smaller pieces. The tubular member is mounted within the dilator sheath adapted to permit the lithotripsy probe to be inserted into the tubular member. The retrieval basket is coupled to the tubular member, and configured for entrapping the concretion and the smaller pieces for their extraction from the body.

Abstract: The present invention is a device for the destruction of adipose tissue comprising two or more ultrasound generators positioned on opposing sides of the treatment area each generating a non-focused wave that converge forming a interferential clash zone with the treatment area therein. Ultrasound generators are contained within a handpiece housing. Furthermore the present invention provides an optional housing having a source of vacuum for encompassing a treatment area whereby the treatment area is drawn bell-shaped into the housing whereupon a pair of shock wave generators are energized to produce cavitational areas within the treatment area and a third interferential energized area between the cavitational areas.

Abstract: A medical device for fragmenting objects and aspirating remaining debris enables a physician or other medical personnel quickly and easily remove objects, such as kidney stones, from a patient. The medical device can include a dual-lumen elongated member and a handle coupled to the elongated member. A first one of the lumens provides a suction passageway, and a second one of the lumens receives a laser fiber for delivering laser energy to an object, such as a kidney stone, within the patient. The handle can include a positioning mechanism to enable the physician by manual manipulation to move and hold in place the laser fiber longitudinally within the second lumen.

Abstract: An ERCP catheter having a removable handle for a lithotriptor compatible basket is disclosed. The removable handle allows the catheter and handle assembly to be removed, leaving the basket in place within the duct and facilitates the use of a lithotriptor for mechanically crushing stone captured in the basket.

Abstract: An apparatus includes an optical fiber extending from a proximal end to a distal end. The optical fiber may include a cladding layer circumferentially disposed about a core layer and a substantially spherically shaped portion at the distal end. The apparatus may also include a first coating circumferentially disposed on a first length of the cladding layer, and a second coating circumferentially disposed on a second length of the cladding layer. The second length may extend distally from a region proximate the distal end of the first coating.

Abstract: Occluding structures may be created within a body lumen by advancing a length of material distally through the body lumen. By drawing a distal location on the advanced length of material in a proximal direction, the material may be compacted into a structure which at least partially occludes the lumen. The occluding structure may be used to remove kidney stones from the ureter in conjunction with lithotripsy and irrigation.

Abstract: A methodology and system for lysing adipose tissue including directing ultrasonic energy at a multiplicity of target volumes within the region, which target volumes contain adipose tissue, thereby to selectively lyse the adipose tissue in the target volumes and generally not lyse non-adipose tissue in the target volumes and computerized tracking of the multiplicity of target volumes notwithstanding movement of the body.

Abstract: Devices, methods, and systems provide a catheter-based device comprising an expandable portion that is placed distally of the obstructive or occluding mass, which substantially prevents fragments generated by ablating the occluding mass with a lithotripter, for example, a laser lithotripter, from traveling upstream, thereby improving the safety and effectiveness of lithotripsy Some embodiments of the device further comprise a through lumen through which fluid is introduced into a renal collecting system, thereby maintains positive pressure that biases the fragments generated by lithotripsy from entering the collecting system.

Abstract: A methodology and system for lysing adipose tissue including directing ultrasonic energy at a multiplicity of target volumes within the region, which target volumes contain adipose tissue, thereby to selectively lyse the adipose tissue in the target volumes and generally not lyse non-adipose tissue in the target volumes and computerized tracking of the multiplicity of target volumes notwithstanding movement of the body.

Abstract: A system and method for a lithotripter is provided. The system can include a shockwave generator and an ultrasonic transmitting/receiving unit, which are in communication with an evaluating unit. The transmitting/receiving unit can include an ultrasonic transducer that emits ultrasonic pulses and receives ultrasonic waves reflected from a target area of the shockwave generator. The evaluating unit can determine a correlation coefficient of the time correlation between the ultrasonic waves and the ultrasonic pulses and provide a signal related to the coefficient. The method can include emitting ultrasonic pulses from the transducer into a body, receiving the ultrasonic waves reflected from a target object in the body, evaluating the received ultrasonic waves with the evaluating unit to determine the correlation coefficient, and providing a signal related to the correlation coefficient.

Abstract: A two-step mammalian biofilm treatment process can have a first step of disrupting or dispersing an undesired biofilm present at a treatment site in or on a mammalian host by suitable mechanical action for example, by applying irrigation fluid, sonic or other vibration, a mechanical instrument or laser-generated mechanical shockwaves to the biofilm. The treatment can also have a second step comprising applying an antimicrobial treatment to the mammalian host to control possible infection related to biofilm dispersed in the first step or to residual biofilm at the treatment site. Usefully, the second step can be performed within a limited time period after the first step. The process can also include additional steps The antimicrobial treatment can employ light or an antibiotic material. Included are implants cleaned of biofilm by a described process.

Abstract: A stone capture device comprises a shaft with a deployable sweeping structure at its distal end. The shaft is adapted to be removably placed over and connected to a conventional ureteroscope. The combination of the stone capture device and ureteroscope can be introduced into the urinary tract to capture, fragment, and remove stones from the bladder and kidney.

Abstract: A system and method for the destruction/ablation of stones, calculi or other hard substances by means of laser energy is disclosed. As a consequence, several important medical treatments can be performed, especially lithotripsy. The system comprises a diode laser source emitting at least at one wavelength, one or more optical fibers which convey laser radiation to the treatment site and a liquid delivery system used for creating a liquid environment around the stones (calculi). The laser device emits at least one wavelength which is highly absorbed in the surrounding/covering medium, thus causing evaporation and cavitation effects that lead to stone/calculi destruction. Different radiation configurations may be used. In one embodiment continuous radiation is used to create sparkler-less plasma bubbles able to destroy hard substances. In another embodiment high peak power pulsed radiation is used. Wavelengths of 1470 nm, 1940 nm, or 1550 nm are preferred.

Abstract: A medical device includes a sheath having a lumen and an elongate member disposed within the lumen of the sheath. The elongate member is moveable relative to the sheath and includes a retrieval assembly. The retrieval assembly has a collapsed position within the lumen of the sheath and an expanded position when extended beyond a distal end of the sheath. The elongate member defines a lumen configured to receive a laser.

Abstract: A stone removal system comprises a sweeping structure and a dilating structure. The sweeping structure is deployed on a kidney side of a urinary stone in the ureter. Should the sweeping structure be unable to remove the kidney stone, the dilating structure is placed on the bladder side of the kidney stone and used to dilate the lumen of the ureter. The dilated lumen allows the sweeping structure to more easily remove the kidney stone. Should the kidney stone still resist removal, a lithotripsy device may be introduced through the ureter and energy directed through openings in the dilation structure to fragment the stone.

Abstract: A medical device for fragmenting objects and aspirating remaining debris enables a physician or other medical personnel quickly and easily remove objects, such as kidney stones, from a patient. The medical device can include a dual-lumen elongated member and a handle coupled to the elongated member. A first one of the lumens provides a suction passageway, and a second one of the lumens receives a laser fiber for delivering laser energy to an object, such as a kidney stone, within the patient. The handle can include a positioning mechanism to enable the physician by manual manipulation to move and hold in place the laser fiber longitudinally within the second lumen.

Abstract: A medical device is provided. The medical device includes a sheath with an extended distal end portion, a proximal end portion, and a lumen defined therethrough. A handle is fixedly connected to the proximal end portion of the sheath, the handle includes an operator that is translatable between a first position and a second position. A flow path is defined within the handle in fluid communication with the proximal end portion of the sheath, wherein the operator is configured to substantially block the flow path in a second position and allow flow therethrough in a first position. The flow path includes a portion that is configured to communicate with a remote source of suction. The handle additionally includes a second inlet portion configured to receive a tool therethrough and allow the tool to extend through the lumen of the sheath.

Abstract: A medical device for fragmenting objects and aspirating remaining debris enables a physician or other medical personnel quickly and easily remove objects, such as kidney stones, from a patient. The medical device can include a dual-lumen elongated member and a handle coupled to the elongated member. A first one of the lumens provides a suction passageway, and a second one of the lumens receives a laser fiber for delivering laser energy to an object, such as a kidney stone, within the patient. The handle can include a positioning mechanism to enable the physician by manual manipulation to move and hold in place the laser fiber longitudinally within the second lumen.

Abstract: An erythema meter includes a probe, a light source of one or more specific probing and reference wavelengths, and an acoustic detector which determines the level of erythema present in the dental pulp chamber of a tooth. The probing and reference wavelengths are delivered in pulsed or amplitude modulated fashion through the probe, thereby permitting electronic identification and filtering of the received data. The absorption of the light wave raises the temperature of the material in the tooth and causes it to expand, thus creating tiny shockwaves which are picked up with the acoustic detector, revealing information on the location of blood and the quantity of blood inside the tooth. The erythema meter accurately measures the erythema, or inflammation, within the tooth in a qualitative and quantitative manner.

Abstract: The invention relates to a single-blow mechanical shockwave generation device used in urological surgery for disintegration of urinary duct stones, comprising a striking device which strikes a shock wave generation device at high speed. The shock waves are transmitted by a shock wave transfer device to an object for destruction with which the shock wave transfer device is in direct or indirect contact. The striking device is displaced by way of the expansion of a high-pressure gas introduced prior to each shock wave generation into an accumulation device. The accumulation device is supplied with high pressure gas from independent gas stores and with supply and sealing devices. The stored gas is released by the manual manipulation of a control device which connects the accumulation device to the striking device.

Abstract: The present invention relates to a vortex bubble removing and cooling system for the electromagnetic shock wave generator in the lithotripter. The vortex bubble-removing and cooling system comprises a water-full cushion (17), a metal diaphragm (14) installed inside the chamber body (27) of the water cushion (17) and a coil (13) which is installed at the backside of the metal diaphragm (14). There is at least one first water nozzle (22) on the side wall of the chamber body (27) and a water suction tube (23) at the center of the chamber body (27). The first water nozzle (22) and the water suction tube (23) form a vortex-generating device. The vortex generated inside the chamber body will scour the surface of the metal diaphragm continuously so as to cool the heat and remove the air bubble. This will make the metal diaphragm be in good working condition and greatly increase the working life of the metal diaphragm and the coil.

Abstract: A methodology and system for lysing adipose tissue including directing ultrasonic energy at a multiplicity of target volumes within the region, which target volumes contain adipose tissue, thereby to selectively lyse the adipose tissue in the target volumes and generally not lyse non-adipose tissue in the target volumes and computerized tracking of the multiplicity of target volumes notwithstanding movement of the body.

Abstract: A methodology and system for lysis or induction of apoptosis in cellulite and fat including directing ultrasonic energy at a multiplicity of target volumes within the region, which target volumes contain cellulite and fat, thereby to selectively lyse or induce apoptosis in the cellulite and fat in the target volumes and generally not lyse or not induce apoptosis in non-cellulite and non-fat tissue in the target volumes and computerized tracking of the multiplicity of target volumes notwithstanding movement of the body.

Abstract: A mechanism and method for steering a surgical instrument inserted into an endoscope such as a ureteroscope, nephroscope, or cystoscope, and/or for steering the endoscope, utilizes a shape memory structure secured to the surgical instrument or to the endoscope, the shape memory structure having a transformation temperature slightly greater than that of the human body so that bending of the shape memory structure, and therefore of the surgical instrument or endoscope, may be carried out by raising a temperature of irrigation fluid in the working channel. The steering mechanism may be used as a supplement to a tensioned-wire steering mechanism, reducing stress on the endoscope shaft and extending the service life and repair interval of the endoscope. In addition, when the surgical instrument is a glass optical fiber, the steering mechanism may be used to ensure that a tip of the optical fiber is within the field-of-view of fiber optics incorporated into the endoscope.

Abstract: An ultrasound diagnostic apparatus for obtaining an ultrasound image of a subject into which an ultrasound contrast agent mainly composed of microbubbles is injected, comprising a probe configured to transmit/receive an ultrasound wave to/from the subject, a transmission circuit configured to drive the probe to transmit an ultrasound wave while sequentially changing a direction of an ultrasound transmission line, a reception circuit configured to generate reception line data of the number of parallel reception from ultrasound echo signals obtained by one ultrasound wave transmission, a transmission/reception control circuit configured to control the transmission and reception circuits to change the number of parallel reception during a scan sequence for generating a 1-frame ultrasound image, and an image processing unit configured to generate an ultrasound image on the basis of the reception line data.

Abstract: The present invention provides a method for treatment of hard tissues, such as stones, present in very small a fluid-filled body cavity, such as ducts of the salivary glands, by applying to said hard tissue, or to the proximity of said hard tissue, a laser beam produced by an Er:YAG laser device.

Abstract: A metal probe for intracorporeal calculi crushing has a point at its distal end with one or several lateral notches next to the probe end. These notches secure a calculus laterally against an adjacent duct wall and thus prevent it from drawing aside when it is crushed by the notch.

Abstract: An ERCP catheter having a removable handle for a lithotriptor compatible basket is disclosed. The removable handle allows the catheter and handle assembly to be removed, leaving the basket in place within the duct and facilitates the use of a lithotriptor for mechanically crushing stone captured in the basket.

Abstract: A medical device is provided which comprises a suction conduit and an energy-transmitting conduit wherein at least some of the transmitted energy is directed to the distal region of the suction conduit. The device may include an optical apparatus for directing the energy. The device has applications in lithotripsy and tissue-removal in a patient.

Abstract: A system and method for a lithotripter is provided. The system can include a shockwave generator and an ultrasonic transmitting/receiving unit, which are in communication with an evaluating unit. The transmitting/receiving unit can include an ultrasonic transducer that emits ultrasonic pulses and receives ultrasonic waves reflected from a target area of the shockwave generator. The evaluating unit can determine a correlation coefficient of the time correlation between the ultrasonic waves and the ultrasonic pulses and provide a signal related to the coefficient. The method can include emitting ultrasonic pulses from the transducer into a body, receiving the ultrasonic waves reflected from a target object in the body, evaluating the received ultrasonic waves with the evaluating unit to determine the correlation coefficient, and providing a signal related to the correlation coefficient.