Abstract: Small diameter tools are provided, and methods of use described, to facilitate less invasive surgical procedures employing laser beams. Such tools include distal tips that enhance the precise placement of optical waveguides, as well as enable cutting and dissecting procedures. A rotary coupler allows precise control of flexible conduits in which waveguides may be disposed. Waveguide tips with conical features protect waveguide ends and allow unobstructed propagation of the laser beam out of the waveguide. A preferentially bending jacket for waveguides may be used to control an orientation of a waveguide disposed therein. Surgical waveguide assemblies may include various combinations of these components.

Abstract: An optical radiation delivery structure including a waveguide conduit having a surgical access portion and a handle portion. The handle portion includes a gripping portion and a waveguide lock, which is configured to have only a locked state and an unlocked state. In some embodiments, the handle portion includes a gripping portion and a counterbalance region, such that a center of mass of the waveguide conduit is disposed towards a proximal end of the waveguide conduit.

Abstract: An optical radiation delivery structure including a waveguide conduit having a surgical access portion and a handle portion. The handle portion includes a gripping portion and a waveguide lock, which is configured to have only a locked state and an unlocked state. In some embodiments, the handle portion includes a gripping portion and a counterbalance region, such that a center of mass of the waveguide conduit is disposed towards a proximal end of the waveguide conduit.

Abstract: A surgical tool and method of use during laparascopic surgery, the tool including a shaft having a distal region with an elastic modulus E. Distal and proximal regions of the shaft have outer diameters D1 and D2 respectively, with D2>D1. The distal region has a bend and terminates in a working feature having a distal end. The distal region has a length L1 measured in a direction parallel to the shaft axis in the proximal region, and has an offset doff relative to the proximal region where doff>D2. The elastic modulus E and the length of L1 are selected so that the working feature is insertable through an access device yet the distal region does not deflect noticeably when a force of 10 N is applied perpendicular to the distal end of the working feature.

Abstract: A surgical tool and method of use during laparoscopic surgery, the tool including a shaft having a distal region with an elastic modulus E. Distal and proximal regions of the shaft have outer diameters D1 and D2 respectively, with D2>D1. The distal region has a bend and terminates in a working feature having a distal end. The distal region has a length L1 measured in a direction parallel to the shaft axis in the proximal region, and has an offset doff relative to the proximal region where doff>D2. The elastic modulus E and the length of L1 are selected so that the working feature is insertable through an access device yet the distal region does not deflect noticeably when a force of 10 N is applied perpendicular to the distal end of the working feature.

Abstract: An optical radiation delivery structure including a waveguide conduit having a surgical access portion and a handle portion. The handle portion includes a gripping portion and a waveguide lock, which is configured to have only a locked state and an unlocked state. In some embodiments, the handle portion includes a gripping portion and a counterbalance region, such that a center of mass of the waveguide conduit is disposed towards a proximal end of the waveguide conduit.

Abstract: A surgical tool and method of use during laparoscopic surgery, the tool including a shaft having a distal region with an elastic modulus E. Distal and proximal regions of the shaft have outer diameters D1 and D2 respectively, with D2>D1. The distal region has a bend and terminates in a working feature having a distal end. The distal region has a length L1 measured in a direction parallel to the shaft axis in the proximal region, and has an offset doff relative to the proximal region where doff>D2. The elastic modulus E and the length of L1 are selected so that the working feature is insertable through an access device yet the distal region does not deflect noticeably when a force of 10 N is applied perpendicular to the distal end of the working feature.

Abstract: In general, in one aspect, the disclosure features a system that includes a flexible waveguide having a hollow core extending along a waveguide axis and a region surrounding the core, the region being configured to guide radiation from the CO2 laser along the waveguide axis from an input end to an output end of the waveguide. The system also includes a handpiece attached to the waveguide, wherein the handpiece allows an operator to control the orientation of the output end to direct the radiation to a target location of a patient and the handpiece includes a tip extending past the output end that provides a minimum standoff distance between the output end and the target location.

Abstract: Small diameter tools are provided, and methods of use described, to facilitate less invasive surgical procedures employing laser beams. Such tools include distal tips that enhance the precise placement of optical waveguides, as well as enable cutting and dissecting procedures. A rotary coupler allows precise control of flexible conduits in which waveguides may be disposed. Waveguide tips with conical features protect waveguide ends and allow unobstructed propagation of the laser beam out of the waveguide. A preferentially bending jacket for waveguides may be used to control an orientation of a waveguide disposed therein. Surgical waveguide assemblies may include various combinations of these components.

Abstract: In general, in one aspect, the disclosure features a system that includes a flexible waveguide having a hollow core extending along a waveguide axis and a region surrounding the core, the region being configured to guide radiation from the CO2 laser along the waveguide axis from an input end to an output end of the waveguide. The system also includes a handpiece attached to the waveguide, wherein the handpiece allows an operator to control the orientation of the output end to direct the radiation to a target location of a patient and the handpiece includes a tip extending past the output end that provides a minimum standoff distance between the output end and the target location.

Abstract: In general, in one aspect, the disclosure features a system that includes a flexible waveguide having a hollow core extending along a waveguide axis and a region surrounding the core, the region being configured to guide radiation from the CO2 laser along the waveguide axis from an input end to an output end of the waveguide. The system also includes a handpiece attached to the waveguide, wherein the handpiece allows an operator to control the orientation of the output end to direct the radiation to a target location of a patient and the handpiece includes a tip extending past the output end that provides a minimum standoff distance between the output end and the target location.

Abstract: In general, in one aspect, the disclosure features a system that includes a flexible waveguide having a hollow core extending along a waveguide axis and a region surrounding the core, the region being configured to guide radiation from the CO2 laser along the waveguide axis from an input end to an output end of the waveguide. The system also includes a handpiece attached to the waveguide, wherein the handpiece allows an operator to control the orientation of the output end to direct the radiation to a target location of a patient and the handpiece includes a tip extending past the output end that provides a minimum standoff distance between the output end and the target location.

Abstract: An apparatus includes a light source configured to provide radiation at a wavelength and a conduit configured to direct radiation at a wavelength from the light source to a target location of a patient. The conduit includes a first optical waveguide extending along a waveguide axis, the first optical waveguide being a flexible waveguide having a hollow core, the first optical waveguide being configured to guide the radiation at through the core along the waveguide axis; and a second optical waveguide extending along the waveguide axis, the second optical waveguide having a hollow core and being coupled to the first optical waveguide to receive the radiation from the first optical waveguide and to deliver the radiation to the target location. The first optical waveguide is a photonic crystal fiber and the second optical waveguide is not a photonic crystal fiber waveguide.

Abstract: In general, in one aspect, the disclosure features a system that includes a flexible waveguide having a hollow core extending along a waveguide axis and a region surrounding the core, the region being configured to guide radiation from the CO2 laser along the waveguide axis from an input end to an output end of the waveguide. The system also includes a handpiece attached to the waveguide, wherein the handpiece allows an operator to control the orientation of the output end to direct the radiation to a target location of a patient and the handpiece includes a tip extending past the output end that provides a minimum standoff distance between the output end and the target location.

Abstract: In general, in a first aspect, the invention features photonic crystal fibers that include a core extending along a waveguide axis, a confinement region extending along the waveguide axis surrounding the core, and a cladding extending along the waveguide axis surrounding the confinement region, wherein the cladding has an asymmetric cross-section.

Abstract: In general, in one aspect, the disclosure features a system that includes a flexible waveguide having a hollow core extending along a waveguide axis and a region surrounding the core, the region being configured to guide radiation from the CO2 laser along the waveguide axis from an input end to an output end of the waveguide. The system also includes a handpiece attached to the waveguide, wherein the handpiece allows an operator to control the orientation of the output end to direct the radiation to a target location of a patient and the handpiece includes a tip extending past the output end that provides a minimum standoff distance between the output end and the target location.

Abstract: In general, in one aspect, the disclosure features a system that includes a flexible waveguide having a hollow core extending along a waveguide axis and a region surrounding the core, the region being configured to, guide radiation from the CO2 laser along the waveguide axis from an input end to an output end of the waveguide. The system also includes a handpiece attached to the waveguide, wherein the handpiece allows an operator to control the orientation of the output end to direct the radiation to a target location of a patient and the handpiece includes a tip extending past the output end that provides a minimum standoff distance between the output end and the target location.

Abstract: In general, in one aspect, the invention features a method that includes exposing a surface to a first gas composition under conditions sufficient to deposit a layer of a first chalcogenide glass on the surface, and exposing the layer of the first chalcogenide glass to a second gas composition under conditions sufficient to deposit a layer of a second glass on the layer of the first chalcogenide glass, wherein the second glass is different from the first chalcogenide glass.

Abstract: In general, in one aspect, the invention features a method that includes exposing a surface to a first gas composition under conditions sufficient to deposit a layer of a first chalcogenide glass on the surface, and exposing the layer of the first chalcogenide glass to a second gas composition under conditions sufficient to deposit a layer of a second glass on the layer of the first chalcogenide glass, wherein the second glass is different from the first chalcogenide glass.

Abstract: In general, in one aspect, the invention features apparatus that include an assembly including a radiation input port configured to receive radiation from a radiation source and an output port configured to couple the radiation to a photonic crystal fiber, the assembly further including a retardation element positioned to modify a polarization state of the radiation received from the radiation source before it is coupled to the photonic crystal fiber.