Abstract: The invention relates to a catheter device including an optical fiber whose distal end is disposed within a hollow tube with a sharp or syringe shaped distal end, which may be inserted into tissue. The distal end of the optical fiber and the hollow tube are configured so as to emit, by refraction (total internal reflection) or reflection from a metal surface, laser energy at an angle of about 80° to about 90° relative to the longitudinal axis of the optical fiber and hollow tube. A first fluid channel within the distal end portion of the tube enables fluid to be infused to cool the distal end of the tube and to cool and clean the emission face of the optical fiber. A second, relatively larger diameter fluid channel in the tube enables the fluid, flowing through said first channel along with hot gasses from the vaporization of tissue, to exit the device through a second port in the tube, away from the tissue being treated.

Abstract: Light energy is utilized to shrink or tighten tissue surrounding a hollow organ, cavity, duct or naturally occurring or surgically created passage by cross-linking the collagen of the surrounding tissue and ccausing scar formation therein. The present device may be used in the esophagus in the area of the sphincter to treat GERD, in the female urethra to treat FSI or at the vesicouretal junction to treat VUR. In the present device, a plurality of plastic tubes, each containing a slidable optical fiber with a sharpened distal end, are affixed to the outer surface of a balloon, which is mounted near the distal end of a closed end catheter. The balloon catheter may be inserted into the body inside a retractable protective sheath. When the sheath is retracted, exposing the balloon, the balloon is inflated, which presses the distal ends of the plastic tubes against the surrounding tissue.

Abstract: Stem cells, bone marrow, or bone marrow enriched with stem cells, is introduced into a host's tissue deficient in blood flow or deficient in a cell type, preferably by creating a trap or pocket within the tissue for confining introduced material. The trap or pocket can be created using mechanical and light energy, or like expedients.

Abstract: A catheter device suitable for shrinking chordae tendineae of the human heart is provided having an energy conduit and a positioning device that facilitates the delivery of thermal energy, including coherent (laser) or non-coherent light, RF, microwave or ultrasound energy, to a predetermined region of the chordae tendineae or other collagen-containing tissue, such as the female urethra or the esophagus near the sphincter. The device comprises a tubular catheter containing an energy conduit, such as a fiber optic cable, adapted for delivering thermal energy to the tissue. The tubular catheter also contain a stabilizing device, disposed at its distal end, such as an asymmetrically shaped balloon or a retractable flexible metal hook. With the distal end of the catheter device positioned within a human heart, application of thermal energy to the chordae tendineae results in a shrinkage of the chordae, providing a treatment for primary mitral valve regurgitation.

Abstract: A medical device applies radiant energy to tissue surrounding or underlying the surface of a duct, hollow organ or body cavity. The energy is emitted through an expandable, energy-transmissive balloon in which a fluid coolant is circulated to cool the surface of the duct, hollow organ or body cavity and the tissue immediately underlying the surface of the duct, hollow organ or body cavity. The device includes an elongated transmission line extending through a catheter, having a proximal end portion, which is connectable to a source of radiant energy, and a distal end portion, to which a radiant energy emitter is coupled. The balloon is mounted on the distal end of the catheter and extends over the emitter. The catheter contains an inlet confined fluid passageway and an outlet confined fluid passageway to provide fluid coolant circulation through the balloon. Microscopic albumen microspheres or particles of quartz or silica are suspended in the fluid coolant to more uniformly diffuse the radiant energy.

Abstract: A lasing device for performing a myringotomy or like procedure is provided. The distal end portion of an optical fiber used to transmit a laser energy beam to the surgical site is covered with a disposable, removably mounted sheath, whose distal end is substantially transparent to the wavelength of laser energy being emitted through the optical fiber. Optionally, a relatively low power aiming beam can be emitted coaxially with the laser energy beam.

Abstract: A device is provided for interstitial delivery of thermal energy and/or a biologically compatible bulking material into tissues in a confined space. The device include means for delivering laser, radio-frequency, electrical, microwave, ultrasound or other thermal energy, as well as a port and channel for concomitant or subsequent injection of a bulking agent. The method of use of the device in the treatment of female stress incontinence (FSI), gastro-esophageal reflex disease (GERD), benign prostate hyperplasia (BPH) and other conditions is described.

Abstract: Stem cells, bone marrow or bone marrow enriched with stem cell compositions suitable for tissue repair are disclosed. Such compositions can be introduced into a host's tissue deficient in blood flow or deficient in a cell type, preferably by creating a trap or pocket within the tissue for confining injected material. The trap or pocket can be created using mechanical and light energy, or like expedients.

Abstract: A computerized method effectively promotes the sale and distribution of medical devices utilized in device-dependent medical or surgical procedures. The method includes maintaining a computerized data directory of a plurality of procedure-qualified medical service providers, providing a user interface to the data directory through a wide access communication network such as the Internet or the public telephone system, receiving an inquiry pertaining to a medical condition of concern to the user, providing information to the user on treatment options for the medical condition of concern, including information on the device dependent medical or surgical procedure, and querying the data directory to find a procedure-qualified medical service provider available to the user. The results of the query are communicated to the user via the user interface.

Abstract: Light energy is utilized to shrink or tighten tissue surrounding a hollow organ, cavity, duct or naturally occurring or surgically created passage by cross-linking the collagen of the surrounding tissue and ccausing scar formation therein. The present device may be used in the esophagus in the area of the sphincter to treat GERD, in the female urethra to treat FSI or at the vesicouretal junction to treat VUR.

Abstract: Particles larger than 7 microns in diameter and containing a therapeutic material are described. Such particles are sufficiently large to lodge in tissue or a blood vessel and can be made to rapidly degrade therein before creating infarcts. Rapid degradation of liposomes containing a therapeutic agent can be achieved by either preparing the liposome in a high salt solution or incorporating in the liposome a component which is stable at or below room temperature, but which becomes unstable at 35° C. or higher. Such particles are useful in delivering, for example, angiogenic growth factors or genes coding for angiogenic growth factors into the coronary arteries of the heart or the heart muscle, as well as other therapeutic agents into organs or tissues or blood vessels feeding the same to achieve a desired effect.

Abstract: A surgical device is provided for forming a channel through or into tissue utilizing both mechanical energy and laser energy. The device includes a needle for forming the first part of the channel. The needle has an open bore. Mounted within the bore is an optical fiber for emitting laser energy to form the balance of the channel.

Abstract: Devices and methods for effective administration of therapeutic drugs or gene therapy to the myocardium is achieved by creating a trap or pocket within the myocardium for confining the injected therapeutic. The pocket can be created using mechanical and light energy, or other means.

Abstract: A surgical device is provided for forming a channel through or into tissue utilizing radio-frequency electrical energy. The device includes a cannula having an open bore. Mounted within the bore is an insulated mono-polar electrical lead, the distal end of which is not insulated, for forming the channel by mechanically advancing through the tissue and emitting radio-frequency energy. Alternatively, the device can have bipolar electrical leads.

Abstract: A surgical device is provided for forming a channel through or partially through vascular tissue, including vascular tissue, utilizing both mechanical and laser energy, and, if desired, depositing a therapeutic agent therein. The device includes an optical fiber for transmission of laser energy, a housing, and a hollow guide attached to the housing through which the optical fiber extends. A needle is attached to the distal end of the optical fiber in fluid communication with a catheter surrounding the optical fiber. Additionally, an actuator is included operably connected to the optical fiber for selectively extending the needle and/or fiber from the hollow guide. Finally, a laser control device is contemplated operably connected to the optical fiber, transmitting laser energy from the distal end of the fiber after the needle has penetrated a layer of selected distance into the tissue.

Abstract: Devices and methods for effective administration of therapeutic drugs or gene therapy to the myocardium is achieved by creating a trap or pocket within the myocardium for confining the injected therapeutic. The pocket can be created using mechanical and light energy, or other means.

Abstract: A variable pulse width lasing device for selectively reducing the amount of laser energy provided during a surgical procedure is described. The device includes a central processing unit, a laser resonator, pulse width detector and a pulse modulator. The central processing unit provides a switch activation command to the modulator. The modulator also receives a laser pulse produced by the laser resonator which has an initial pulse width and a wavelength which is compatible for transmission through an optical fiber. The modulator varies the width of the laser pulse for providing an output pulse at a selected pulse width and energy level.

Abstract: A surgical device is provided for forming a channel through or into tissue utilizing both mechanical energy and laser energy. The device includes a needle for forming the first part of the channel. The needle has an open bore. Mounted within the bore is an optical fiber for emitting laser energy to form the balance of the channel.

Abstract: A method of percutaneous and subcutaneous laser treatment of the tissue of a patient is provided. The tip of an optical fiber is be passed through the skin, advanced through the tissue subcutaneously to a desired treatment area and withdrawn. Laser energy can be emitted at different levels during any or all of the skin penetration, advancement, tissue treatment and withdrawal phases. The present invention is useful for surgical treatments, and is especially suitable for minimally invasive plastic or cosmetic surgical and dermatological procedures without bleeding and with less edema, erythema and swelling and faster healing than conventional surface laser energy application, abrasion, scalpel surgery or chemical peel procedures.

Abstract: A surgical device is provided for forming a channel through or into tissue utilizing both mechanical energy and laser energy. The device includes a needle for forming the first part of the channel. The needle has an open bore. Mounted within the bore is an optical fiber for emitting laser energy to form the balance of the channel.