Abstract: A combined laser and ultrasonic device includes a combination laser and ultrasonic source, a control console and a combined laser and ultrasonic delivery handpiece. The system has three modes of operation: 1) laser energy only, 2) ultrasonic energy only and 3) combined laser and ultrasonic energy. All three modes of operation are controlled by a single foot-operated activation switch, which will operate the laser source, the ultrasonic source or both, depending on which mode the device is operating in according to a mode switch on the control console. The combined laser and ultrasonic delivery handpiece includes an ultrasonic transducer coupled to an ultrasonic vibrating tip, which is mounted in close proximity to a laser delivery wave guide, such as a flexible optical fiber. The combined laser and ultrasonic device can be used to perform a variety of surgical procedures, including an improved method of a laser excisional new attachment procedure (Laser E.N.A.P.

Abstract: The present invention relates generally to a laser cutting scalpel for use in medical and other applications, and more particularly, to such an apparatus wherein the transmitted radiation is delivered at an angle to the incident radiation source and tool. The invention is capable of coagulating, cutting or vaporizing tissue and may be useful in a wide range of surgical and non-surgical applications. The device has a firing tip which has an insert with a highly polished mirrored surface lying at a specific angle with respect to the central longitudinal axis of the optical fiber. Thus impinging laser radiation is reflected to the side and delivered at approximately a right angle to the fiber. The invention also features one or more cooling vents located in the firing tip itself resulting in a device less prone to failure during operation. The device can be positioned accurately with respect to depth of insertion of the fiber.