Abstract: An end-firing surgical laser fiber suitable for Thulium Laser Fiber lithotripsy applications includes an internally reflective tube that extends beyond the distal end surface of the fiber to provide a standoff sleeve, and that is welded or otherwise fixed to an end section of the fiber. The standoff sleeve may be made of silica glass or sapphire, a reflective metal, and/or may include a reflectivity-enhancing coating or structure on an inner surface of the tube. In addition, the reflective standoff sleeve may be tapered to increase or decrease a diameter of a distal end of the sleeve to control output power density, and may include index matched fillers or structures that absorb, transmit, or scatter energy away from the fiber cladding, and/or an energy blocking or absorbing structure positioned at an upstream end of the sleeve.

Abstract: A side-firing laser system with a standoff catheter includes an optical fiber configured to emit therapeutic laser radiation in a direction generally transverse to an axis of the fiber; and a catheter through which the optical fiber is inserted during a surgical procedure. The catheter includes a transparent end section through which the therapeutic laser radiation passes to vaporize tissue outside the catheter, an open distal end to permit exit of irrigation fluid from the catheter, and an opening in a side of the end section, the opening having dimensions that are approximately equal to or less than cross-sectional dimensions of the therapeutic laser radiation. When the fiber is moved to a position at which the therapeutic laser radiation passes through the opening, the laser radiation causes coagulation or vaporization of tissues.

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: 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 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 side-firing laser system with a standoff catheter includes an optical fiber configured to emit therapeutic laser radiation in a direction generally transverse to an axis of the fiber; and a catheter through which the optical fiber is inserted during a surgical procedure. The catheter includes a transparent end section through which the therapeutic laser radiation passes to vaporize tissue outside the catheter, an open distal end to permit exit of irrigation fluid from the catheter, and an opening in a side of the end section, the opening having dimensions that are approximately equal to or less than cross-sectional dimensions of the therapeutic laser radiation. When the fiber is moved to a position at which the therapeutic laser radiation passes through the opening, the laser radiation causes coagulation or vaporization of tissues.

Abstract: A side-firing laser system with a standoff catheter includes an optical fiber configured to emit therapeutic laser radiation in a direction generally transverse to an axis of the fiber; and a catheter through which the optical fiber is inserted during a surgical procedure. The catheter includes a transparent end section through which the therapeutic laser radiation passes to vaporize tissue outside the catheter, an open distal end to permit exit of irrigation fluid from the catheter, and an opening in a side of the end section, the opening having dimensions that are approximately equal to or less than cross-sectional dimensions of the therapeutic laser radiation. When the fiber is moved to a position at which the therapeutic laser radiation passes through the opening, the laser radiation causes coagulation or vaporization of tissues.

Abstract: A surgical laser delivery systems utilizes a standoff catheter to prevent contact and/or maintain a predetermined spacing between the laser delivery fiber or fiber assembly and the target. The standoff catheter includes multiple side-firing ports. The side-firing ports may include openings of the same or different dimensions, at least one diffuser, and/or at least one lens, to permit the operator to control the degree of vaporization/coagulation and/or vary lasing parameters without having to withdraw the optical fiber from the patient, by rotating or linearly moving the laser or laser assembly with respect the standoff catheter. The side-firing ports may also include an opening at the front of the stand-off catheter to enable use with a forward-firing laser fiber or fiber assembly.

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 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 welding a protective structure to a tip of a surgical laser fiber involves inserting the optical fiber into a length of tubing, and positioning the fiber and the tubing in a rotatable fixture arranged to simultaneously rotate the fiber and tubing while laser radiation is directed through a transparent material of the tubing, so that one or both contacting surfaces of the tubing and the fiber absorb the laser radiation and heat up to weld the tubing to the fiber. The tubing may be a length of polymer material.

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: The need for persons to move around a crowded operating room during a surgical procedure is reduced by providing each of the persons tasked with operating surgical equipment, such as a laser, with a portable or handheld communication device capable of transmitting instructions and commands necessary to operate the laser, and by further providing each person in the operating room whose duties require observing a monitor with display devices capable of displaying video and other information shown on the monitor. The handheld wireless communication devices may be smartphones or tablets, and the display devices may be separate wireless display devices or displays of the smartphones or tablets.

Abstract: A soft tip is used to trap and pulverize stone fragments between the stone and the end of a single fiber, fiber bundle or lenticular array during a pulsed laser lithotripsy procedure.

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 method of reducing retro-repulsion of a kidney stone during a laser lithotripsy procedure utilizes a protective cap or sleeve fitted onto an end of the laser delivery fiber and extending a predetermined distance beyond a tip of the fiber to prevent contact between the tip of the fiber and a stone to limit retro-repulsion by maintaining contact between the protective cap and the stone, thereby limiting the amount of water in the path of the laser between the fiber tip and the stone. The method may further include the step of firing the laser only when contact between the protective cap and the stone is detected, implemented manually or by a contact detection system. The fiber tip may be outwardly tapered to collimate the laser beam and allow an increased spacing between the fiber tip and the distal end of the protective cap.

Abstract: Interchangeable tips and/or catheters are placed over a surgical laser optical fiber to allow different side and forward firing outputs. The different side firing outputs may be achieved by securing tip structures having different angled reflectors to a ferrule at the end of the fiber. The absence of any tip structures allows forward firing through the ferrule.

Abstract: A side-firing laser system with a standoff catheter includes an optical fiber configured to emit therapeutic laser radiation in a direction generally transverse to an axis of the fiber; and a catheter through which the optical fiber is inserted during a surgical procedure. The catheter includes a transparent end section through which the therapeutic laser radiation passes to vaporize tissue outside the catheter, an open distal end to permit exit of irrigation fluid from the catheter, and an opening in a side of the end section, the opening having dimensions that are approximately equal to or less than cross-sectional dimensions of the therapeutic laser radiation. When the fiber is moved to a position at which the therapeutic laser radiation passes through the opening, the laser radiation causes coagulation or vaporization of tissues.