Abstract: An end-firing surgical laser fiber suitable for Thulium Laser Fiber lithotripsy applications includes a standoff that extends beyond the distal end surface of the fiber to prevent contact between the end face of the fiber and a targeted stone. The standoff may either (1) extend along only one side of or partially around a circumference of the fiber, so that dust from the pulverized stone can freely flow downstream from the treatment site without being trapped by or accumulating on the standoff, or (2) include at least one flushing port that prevents dust accumulation by permitting passage of dust from within the standoff. Flushing of dust from within the standoff may be facilitated by including a source of fluid to entrain the dust and carry it through the flushing port.

Abstract: A method for preventing undesired tissue coagulation or sloughing during a laser ablation or vaporization procedure involves setting a predetermined usage limit based on objective criteria indicative of wear and/or debris accumulation on a catheter or sleeve through which a surgical laser is fired, and replacing or re-positioning the catheter or sleeve when the predetermined usage limit is exceeded.

Abstract: A system and method for detecting relative location of a surgical laser fiber tip relative to a surgical laser target during a surgical laser procedure utilizes a spectrophotometer to detect radiation indicative of the relative location. For example, the detected radiation may indicate contact between the fiber tip and a stone being subjected to laser lithotripsy, so as to prompt the surgeon to withdraw the fiber tip from the stone and/or take other action to limit contact-induced erosion of the fiber tip, and to avoid saturation of the endoscope camera resulting from the flash that occurs following contact. In addition, the absence of any detected radiation by the spectrophotometer may be used to indicate that the stone is no longer present, or that the fiber tip is no longer aimed at the stone, prompting the operator to reposition the fiber and/or temporarily cease firing of the laser.

Abstract: A protective structure for the distal treatment end of a surgical laser fiber inserted into a patient through a scope includes uniformly-spaced ruler or scale markings that are visible through the scope and that enable the size of an object within the field of view of the scope to be precisely determined.

Abstract: A method of reducing retro-repulsion of a stone during a laser lithotripsy procedure involves the use of a spacer tip or standoff sleeve to create a passage between the tip of a fiber and a stone, and to prevent collapse of a bubble formed by vaporization of and/or gas pressure on liquid present in the passage. The laser radiation may consist of continuous or quasi-continuous wave radiation that is relatively low in power compared to the therapeutic pulses, or may consist of the therapeutic pulses if the pulse frequency is high enough to prevent collapse of the bubble between pulses. The spacer tip or standoff sleeve further prevents collapse of the bubble and ingress of liquid into the laser path. The spacer tip or standoff sleeve may be a generally-cylindrical protective cap that is fitted to an end of the optical fiber and that extends beyond the fiber tip to provide a predetermined spacing or standoff between the fiber tip and the stone when the protective cap is in contact with the stone.

Abstract: A distal end of an optical fiber may be protected by a variety of alternative protective caps, tips, and/or sleeves. In one example, a generally cylindrical soft tip is arranged to fit over the end of the fiber, and to compress in an axial direction when pressed against a stone to allow a recessed tip of the fiber to contact the stone or to be maintain a minimum spacing between the fiber tip and the stone and thereby limit erosion of the fiber tip.

Abstract: An arrangement that prevents carbonization of cladding, coating, or buffer layers of a surgical laser fiber due to thermal radiation reflected back into the fiber from, or emitted by, a target of the laser, includes a thermal radiation blocking, absorbing or diverting structure. The thermal radiation blocking, absorbing or diverting structure surrounds an end portion of the fiber that has been stripped of one or more coating and/or buffer layers, and may be made of a heat resistant material such as PTFE or polyimide to block heat from reaching the coating or buffer layers, an optical ferrule such as fused silica to guide the heat away from the fiber coating or buffer layers, or a high refraction index material such as UV adhesive.

Abstract: A protective ferrule for an end-firing optical fiber arrangement combines a spherical or rounded shape with a planar end. The combination of the spherical or rounded shape and planar end provides protection for the working channel of an endoscope or catheter through which the fiber is inserted while confining and minimizing erosion of the active surface area of the fiber. The protective ferrule of may be fitted to the end of the optical fiber by the steps of heating the ferrule to expand an inside diameter so that it fits over the end of the fiber, with subsequent cooling of the ferrule causing it to contract and create a compression fit.

Abstract: A first structure made of a first polymer is joined to a second structure made of an incompatible second polymer by the steps of welding small bands of compatible tubing or material to the first structure to create raised structures or ribs, and mechanically linking the second structure with the ribs or raised structures at the desired attachment point. The mechanical linkage may be accomplished by using heat shrinking or mechanical compression (such as crimping) to force the incompatible second polymer around the ribs or raised structures or, in the case of raised structures formed as threads or nubs, by inter-engagement between the threads or nubs on the first structure and corresponding structures, such as internal threading, nub-receiving slots, or internal surfaces, of the second structure.

Abstract: A system and method for detecting relative location of a surgical laser fiber tip relative to a surgical laser target during a surgical laser procedure utilizes a spectrophotometer to detect radiation indicative of the relative location. For example, the detected radiation may indicate contact between the fiber tip and a stone being subjected to laser lithotripsy, so as to prompt the surgeon to withdraw the fiber tip from the stone and/or take other action to limit contact-induced erosion of the fiber tip, and to avoid saturation of the endoscope camera resulting from the flash that occurs following contact. In addition, the absence of any detected radiation by the spectrophotometer may be used to indicate that the stone is no longer present, or that the fiber tip is no longer aimed at the stone, prompting the operator to reposition the fiber and/or temporarily cease firing of the laser.

Abstract: A method of reducing retro-repulsion of a stone during a laser lithotripsy procedure involves the use of a spacer tip or standoff sleeve to create a passage between the tip of a fiber and a stone, and to prevent collapse of a bubble formed by vaporization of and/or gas pressure on liquid present in the passage. The laser radiation may consist of continuous or quasi-continuous wave radiation that is relatively low in power compared to the therapeutic pulses, or may consist of the therapeutic pulses if the pulse frequency is high enough to prevent collapse of the bubble between pulses. The spacer tip or standoff sleeve further prevents collapse of the bubble and ingress of liquid into the laser path. The spacer tip or standoff sleeve may be a generally-cylindrical protective cap that is fitted to an end of the optical fiber and that extends beyond the fiber tip to provide a predetermined spacing or standoff between the fiber tip and the stone when the protective cap is in contact with the stone.