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: 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: 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: 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: In general, in one aspect, the invention features methods that include directing radiation to a target location of a patient through a photonic crystal fiber, the photonic crystal fiber having a hollow core and flowing a fluid through the hollow core to the target location of the patient.

Abstract: In general, in one aspect, the invention features methods that include directing radiation to a target location of a patient through a photonic crystal fiber, the photonic crystal fiber having a hollow core and flowing a fluid through the hollow core to the target location of the patient.