Abstract: An apparatus and a method are provided in which a cylindrical body is shaped and sized to sealingly and closely fit into a conventional cannula. An elongate surgical instrument is inserted into the cylindrical body through a resilient seal so as to extend past and be in pressing contact with distal ends of a plurality of bristles supported to the cylindrical body inside a distal end thereof. The sealing element and the bristles cooperate to support the surgical instrument substantially axially of the cylindrical body and the cannula within which it is contained. Relative motion of the surgical instrument causes a rubbing action of the bristles contacting its outer surface and this serves to remove any incidental surgical debris, e.g., excised tissue, coagulated fluids, and the like, from the bristle-contacted outer surface of the surgical instrument both when it is moved during use and when it is removed from the cylindrical body.

Abstract: A coaxial electrosurgical instrument has an elongate inner electrode insulated from and contained coaxially within a hollow tubular elongate outer electrode. Both electrodes have respective distal end portions which are uninsulated and contactable simultaneously to tissue to be operated on. A controlled, high-frequency, potential difference is provided between the electrodes under the user's control when the uninsulated distal end portions thereof are simultaneously contacted to tissue. A high frequency, high density, electrical current is thus caused to flow substantially only through that part of the contacted tissue which lies between the contacting portions of the inner and outer electrodes. Tissue is readily and cleanly cut between the inner and outer electrodes applying a continuous, undamped high frequency voltage difference.

Abstract: Apparatus and method are provided to ensure efficient transmission of a light flux from a first optic element to a second optic element located close to but not in intimate contact therewith. This is accomplished by providing an intermediate element made of a light-transmissive conformable material which is disposed so as to be simultaneously pressed to both a light-transmitting surface of one element and a light-receiving surface of the second element. Selection of a suitable material for the conformable element ensures the desired optical transmissibility and intimate contact, and thereby significantly reduces Fresnel and other losses of the type normally encountered when two relatively hard optic elements cannot be placed in intimate contact with each other. Commercially available two-component silicone rubber materials are found to be suitable for forming the light-transmissive conformable optic element.

Abstract: An endoscopic tool has an elongate cylindrical cannula with an open hooked end insertable into the body of a patient with a trocar element providing a laser powered flux of energy for precise incision and optional cauterization of tissue. A conventional pointed trocar may be used with the hooked cannula to permit forcible insertion of the hooked cannula end to the selected surgical site. In the alternative, a laser energy conveying trocar may be used with the hooked cannula or homeostatic insertion into the patient's body. The active distal end portion of the trocar may be provided with a selectively shaped energy-delivering tip element. The energy-delivering tip element may be provided with a subsurface heating region in which a selected implanted material converts received laser energy into heat for application to tissue held in the hooked open end portion of the cannula.

Abstract: A cap-like tip element is shaped and sized to fit over an energy-delivering distal end portion of an optic fiber conveying a flux of optic energy from a selected energy source. Optic energy emitted from an energy-emitting surface of the enclosed distal end of the optic fiber is received at a surface inside the tip element. In the preferred embodiment of the invention, the tip element is optically transmissive, and is shaped to facilitate precisely directed application of optic energy emitted therefrom. The material of the tip element is selected to be durable in prolonged use through repeated thermal cycling. In another aspect of the invention the tip element material is selected to be electrically conductive and is connected to an independently controlled electrical voltage source so that the tip element may be used as a cauterization tool by direct contact to selected tissue.

Abstract: A laser light energy powered device for providing directed emission of laser light energy has a blunt, i.e., non-sharp, laser light emitting tip element. The tip element is preferably formed as a slab defined by two pairs of parallel sides, a proximal end face for receiving laser light energy conveyed thereto through an optic fiber, and a laser light energy emitting curved-sided distal end surface. The curved side surface is contiguous at one end with one of the elongate parallel sides defining the tip element. All surfaces are smooth and polished in one embodiment and laser light energy is emitted therefrom in a first portion focused generally forwardly of the distal end of the tip element and in a second portion emitted laterally of the end portion of the tip element.

Abstract: A tip element is provided for attachment to a small hand-held elongate surgical tool, to enable a surgeon to utilize laser light energy conveyed along a single optical fiber and converted at a fine point of the tip element into a high temperature energy flux. Thus, instead of emitting laser light energy directly to a patient's tissues, the surgeon applies an extremely hot pointed tip very precisely to generate such high local temperatures as to substantially vaporize or gasify the tissue. An annulus is defined adjacent to and immediately around the heated portion of the tip element so that vapors and gaseous products generated during use of the device are immediately removed from the surgical site. An electrical connection may be provided to a distal portion of the tip element close to its heated point to enable a surgeon to contact a bleeding blood vessel thereby to effect cauterization by a cauterization current driven through the patient's body and controlled by a foot-operated switch.

Abstract: A thin layer of a material having a refractive index that varies non-abruptly between the refractive indexes of a first element and a second element in an optical device significantly reduces Fresnel losses in transmitting light from the first element into the second element. The layer is readily created by either an ion beam mixing process or by an ion beam enhanced deposition (IBED) process, forming a region of non-abruptly varying refractive index in one of the elements at an interface therebetween. A selected material is thus securely bonded into the laser light-receiving element which may conveniently be made of a material such as YAG, silica, sapphire, zirconia, quartz, silicon, germanium, zinc sulfide or zinc selenide, depending on the application at hand. In another aspect of this invention, the tip element is provided with an additional layer over the first layer to provide added protection thereto.

Abstract: A laser energy delivery tip element for applying laser energy received through an optical fiber has a foraminous element disposed to receive laser light energy emitted from the optical fiber to be heated thereby. The heated portion of the foraminous element is disposed to be contacted to a tissue so as to heat and vaporize a portion of the tissue to form an incision. Suction is applied to the laser energy tip element to immediately draw away from the incision site any gaseous and/or vaporized substances generated during its use to apply heat, the sucked-away substances passing through openings in the foraminous element and around and outside the optical fiber, to thereby facilitate viewing of the incision-making activity.

Abstract: A thin layer of a material having a refractive index that varies non-abruptly between the refractive indices of an optic fiber and a tip element in a laser device significantly reduces Fresnel losses where the optic fiber meets the tip element. The layer is readily created by either an ion beam mixing process or by an ion beam enhanced deposition (IBED) process for forming a layer of varying refractive index and comprising a ceramic material such as silica, very securely bonded into the laser light energy receiving end of the tip element which may conveniently be made of a ceramic material such as YAG, silica or sapphire. Greater utility of such a tip element is realized by providing an ohmic heating layer over a part of the tip element.