Abstract: A liquid core laser optical scope for illuminating, viewing, and delivering laser energy to a site in a lumen of an animal or human body which includes a flexible tube for insertion into the lumen, a conduit housed within the tube, a fluid source for coupling a flow of light transmissive liquid into the conduit, a light source for transmitting visible light through the tube to illuminate the site, an optical fiber bundle having an optical receiving end disposed at the distal end of the optical scope for imaging the illuminated site and transmitting a visible image thereof through the optical scope to an external viewing port, and a fluid core light guide for transmitting laser energy from an energy source into the conduit where the conduit has a sidewall capable of internally reflecting light into the liquid in the conduit so that the liquid waveguides the laser energy through the conduit to the site.

Abstract: A plurality of microminiature light sources (10, 10') are injected at a treatment site to effect photodynamic therapy (PDT). Each of the microminiature light source beads includes an LED chip (12), a rectifier chip (14), and a plurality of electromagnetic receivers (18, 18') encapsulated within a biocompatible, light transmitting material such as silicone, forming a spherical bead that is only a few millimeters in diameter. The light source beads are sufficiently small so that they can be injected into a treatment site such as a tumor (46) from a syringe (58) through a needle (60). A photoreactive agent, which can serve as a carrier fluid for the microminiature light source beads, sensitizes the tissue at the treatment site so that light emitted by the LED chip when energized with an external electromagnetic transmitter (34) kills the tissue or other pathogens at the treatment site that have absorbed the photoreactive agent.

Abstract: An improved medical laser treatment system and method generates a beam of laser energy at a predetermined wavelength; transmits the beam of laser energy along a path to a medical treatment site; delivers to the medical treatment site an insufflating gas which is absorbent at the predetermined wavelength; and introduces into the path of the beam of laser energy a non-absorbent purge gas which is transparent to the predetermined wavelength of the laser, at a flow rate for opposing the influx of insufflating gas to reduce the resonant absorption of the laser beam energy.

Abstract: A system for delivering a probe into a body part to perform a therapeutic or diagnostic procedure therein which includes an elongated probe device which is disposed within a protective sheath and which has a rotary drive unit connected to its proximal extremity to rotate the probe about its longitudinal axis, preferably at a rate above 50 rpms while applying axial pressure thereto to cause the distal end of the probe to penetrate through the patient's tissue to a desired location in the body part where the procedure is to occur. In a presently preferred embodiment, the probe is an optical fiber which is delivered into a male patient's prostate gland through the patient's prostatic urethral wall. The optical fiber is optically connected to a source for laser energy (815 nm) which is emitted from the distal end of the optical fiber to ablate prostatic tissue surrounding the distal end.

Abstract: An operating microscope has extensions on which are mounted neon lasers which focus beams through the focal point on the optical axis of the operating microscope. The beams produce two spots on an object when the object is away from the focal point, and a single spot on an object at a the focal point. Lightweight laser ring gyroscopes are connected to the operating microscope to determine spatial changes in the position and direction of the operating microscope and the focal point of the microscope.

Abstract: An illuminator including a differential optical radiator and a laser fiber disposed within the differential optical radiator. The differential optical radiator includes a first region that has a first level of reflectivity and a first level of transmissivity and a second region that has a second, higher level of reflectivity and a second, lower level of transmissivity. The first and second regions are positioned such and their reflectivities and transmissivities are chosen such that the radiator produces a substantially uniform pattern of illumination from the first and second regions.In another embodiment, the illuminator includes an expandable radiator and a laser fiber disposed within the expandable radiator. The reflectivity of the expandable radiator is such that the illumination at the outer surface of the expandable radiator is substantially uniform.

Abstract: A method is provided for facilitating the atrophying of a tonsil or adenoid ("organ") to cause the gradual removal thereof from the patient. A laser is positioned adjacent the organ, the wavelength for the laser being in the 700 nm to 1100 nm range and having energy sufficient to cause coagulation of blood in at least a significant number of the organ vessels over a period of several minutes, but not so much energy as to kill significant tissue of the organ or to cause significant damage to tissue adjacent to the organ. The laser is then turned on to irradiate the organ with laser energy and the entire exposed area of the organ is painted or otherwise irradiated. Irradiation continues until a selected condition of the organ, tissue adjacent the organ and/or laser source occurs.

Abstract: Apparatus for irradiating an area with a controllable pattern of light comprises a laser (2), which illuminates a spatial light modulator (6). The resulting spatially modulated light then passes to a cholesteric liquid crystal polymer beam-splitter (10) which reflects it to an image surface (13) of an endoscope (12). The endoscope relays it to another image surface (40) whence it is focussed on the area to be irradiated. This light may be used for photodynamic therapy.

Abstract: The device of the present invention pertains to a modified medical laser delivery device with sideways directed radiation that can produce high power densities at a distance further away from the fiber, thereby enabling non-contact ablating procedures to be carried out with lower laser input power levels.

Abstract: The present invention involves a medical delivery system capable of emitting radiation with wavelengths between 190 nm and 16 um in one or more essentially directed, predetermined patterns. It includes at least one solid optical fiber, having a core and a cladding on the core. The cladding has a refractive index smaller than the core, having an input end suitably configured to connect to an appropriate radiation source and having a distal end in the proximity of which two or more grooves are penetrating into the core. The grooves have at least partial reflector capability so as to deflect radiation thereto radially in one or more predetermined patterns. The invention also includes methods of performing medical procedures utilizing the aforesaid device.

Abstract: A method and apparatus for dilating blood vessels in vasospasm through the use of high frequency wave, e.g., hydraulic or acoustic waves. The invention is suitable to treat any vasospasm, including any vasospasm intractable to medication, including cerebral vasospasm, which currently is not susceptible to any mechanical or chemical treatments. The apparatus for dilating blood vessels includes a catheter having a fluid-filled lumen, a wave generator arranged within the catheter lumen for generating a wave front that propagates through the fluid in the lumen and is transmitted from the distal end of the catheter to propagate through the fluid in the blood vessel, and an energy source connected to the wave generator to provide energy to produce the wave front.

Abstract: An improved vaginal speculum for photodynamic therapy of intraepithelial tissue and in particular vaginal, cervical and vulvar neoplasia utilizes a precisely and accurately positionable optic fiber through which a predetermined dose of light in the range of 620 to 700 nanometers is delivered over a controlled area which has been previously treated with photodynamic therapeutic substances. In particular, the neoplastic area has been treated with hematoporphyrin derivatives and other photosensitizers which are selectively taken into the cancerous tissue. Exposure to the appropriate wavelength laser light photoactivates the absorbed hematoporphyrins causing the release of singlet oxygen which internally oxidizes and ultimately causes cell death.

Abstract: The invention features a treatment method of deeply seated tissue and a corresponding medical instrument. The medical instrument includes a light guide adapted to transmit light energy of a selected wavelength from a light source to a selected volume of tissue, a conduit constructed to deliver a flow of coolant from a source of coolant to a surface of the selected tissue volume through which the light energy passes in reaching the volume. The irradiation and cooling is governed by control means adapted to regulate the intensity of the light energy in respect of the flow of coolant delivered to the surface to prevent substantial damage of surface tissue while irradiating the tissue volume.

Abstract: An endoscopic light delivery system for delivering light to tissue includes a laser source for generating light. Fiber optics are optically coupled to the laser source for conveying the light generated by the laser source. A focusing surface is formed at an end of the fiber optics. The focusing surface of the fiber optics is shaped for redirecting light conveyed by the fiber optics in a direction lateral to the fiber optics for cutting tissue. A single optical fiber or a bundle of optical fiber can be used to transmit plural wavelengths of light for aiming cutting and coagulating.

Abstract: Articles of manufacture which are adapted for use in contact with one or more biologically active agents are coated with a glassy carbohydrate film. The glassy film provides a reduced surface energy coating which exhibits a reduced degree of binding with biologically active agents. Methods for applying the glassy carbohydrate film are disclosed wherein the glassy film is adsorbed directly onto the article surface. The coated articles are for use both in vitro and in vivo where contact with biologically active agents is expected.

Abstract: This invention relates to a surgical instrument. Specifically, a surgical instrument is disclosed which dispenses incising, transecting, or tissue treating energy to a body site or part undergoing an operation or treatment where energy is discharged from a conduit to effect the treatment. The disclosed instrument is inserted to an operative site that effectively rules out proximal manipulation of the instrument. Therefore, proximal insertion with subsequent distal manipulation excluding proximal side-to-side or up and down manipulation is disclosed. The disclosure further includes a deployable shield and is ideal for operative engagement to surgical sites on the body such as the carpal tunnel, tarsal tunnel, the wrist, temporomandibular joint, or scar tissue capsules forming around implants of the breast.

Abstract: A method and system for reshaping Bowman's membrane, which lies directly below the anterior epithelial surface of the cornea, to provide correction of refractive errors in the eye by photoablation of selective regions of the Bowman's membrane without substantial penetration into the stroma of the eye is disclosed including a laser and a beam-shaping mask, disposed between the laser and the surface of the cornea, which imposes a defined ablation profile upon the Bowman's membrane by laser radiation. The system can also include a feedback control for measuring the effectiveness of the laser during operation and for controlling the laser such that the reprofiling operation is substantially confined to the Bowman's membrane throughout the procedure. The beam-shaping mask can include either an aperture e.g.

Abstract: This invention relates to a process for incising the transverse carpal ligament in the hand for relief of the symptoms of carpal tunnel syndrome. More specifically, a process is disclosed in which incising energy, preferably laser energy, is introduced from under the ligament for transecting the transverse carpal ligament while permitting the surgeon to view the interface of transection. A probe, preferably attached to a pistol-type grip, includes at least one tube containing an optic viewing device (preferably fiber-optic), and a conduit for directing incising radiation for the ligament transection. The fiber-optic viewing device, energy conduit, and an optional suction tube commence at the pistol grip where they are connected to the requisite viewing device, energy source, and suction pump. The fiber-optic viewing device terminates at a sufficient distance from the pistol grip to permit extension from the insertion at the wrist to pass under the entire length of the transverse carpal ligament.

Abstract: Disclosed is a light angioplasty catheter and method for exposing the interior of a body lumen to a source of light. Light exposure may be accomplished prior to, during, or following conventional balloon dilatation. Also disclosed is a method and apparatus for exposing a preselected portion of vessel wall to a source of light. Relatively low energy light exposure has been found by the inventors herein to both inhibit restenosis following dilatation of a stenotic region, and to inhibit vascular spasms whether or not associated with a stenotic region. It may also arrest progress of a stenosis. Methods are also disclosed for cooling the vascular wall to treat a stenosis. Cooling may be accomplished prior to, during, or following dilatation.

Abstract: A hand-held portable arthroscope has a housing and a disposable cap removably attached to the distal end of the housing. A probe which includes a fiber optic image guide and a plurality of optical illuminating fibers is mounted on the cap, and is insertable into a body for imaging the internal structure of the body. The illuminating fibers extend through the cap and are connected in light communication with a quartz halogen lamp for illuminating the internal body structure being imaged. To gather light from the illuminated internal structure of a body into which the probe has been inserted, a GRIN rod is attached to the distal end of the image guide. Focussing optics are mounted in the housing in light communication with the image guide. These focussing optics are axially movable within the housing for focussing the image from the image guide. Light which passes through the focussing optics enters a camera head which is also mounted in the housing.

Abstract: A method is disclosed for determining the biodistribution of substances using fluorescence spectroscopy. A photosensitizing agent or other intrinsically fluorescent agent, or an agent labeled with an extrinsic fluorophor is administered to a subject. A fiberoptic probe integrated with an excitation light source illuminates the examined tissue and causes fluorescence. The fluorescence is recorded by a spectrograph and plotted as a spectral curve. The intensity ratio (S1/S2) for the fluorescence from the photosensitizing agent (S1) and autofluorescence (S2) for the examined tissue is used as an index for drug presence and compared with the intensity ratio at the same wavelengths for various tissues.

Abstract: A medical laser treatment device comprising a laser generation source and a laser handpiece which comprises a light-guiding fiber used to guide a laser beam irradiated from the laser generation source, a probe for guiding the laser beam having been guided by the fiber to an object to be irradiated, at least two independent air supply passages and at least one water supply passage, the laser handpiece being adapted such that the emission end of the light-guiding fiber is airtightly isolated from the incident end of the probe via a light-guiding shield plate to make the internal section of the light-guiding fiber airtight, to cool the emission end of the light-guiding fiber using dry gas supplied from the first air supply passage and to cool the incident end of the probe using gas supplied from the second air supply passage, and being also arranged such that water supplied from the water supply passage is blown out from the peripheral section of the leading end of the probe, thereby preventing the emission end

Abstract: A method for preventing platelet adhesion to a vascular surface in a mammal, which includes irradiating the vascular surface with a pulse of laser energy having a pulse duration less than the thermal relaxation time of the irradiated vascular surface, wherein lasar energy is delivered to said vascular surface via radiographic contrast material.

Abstract: A CO2 laser system which includes the CO2 laser unit, a microscope for receiving the laser beam and directing the beam to the infected area; a modified air cystoscope which further comprises a first primary member having a shaft portion with a continuous bore therethrough; a flare neck portion, and a handle member attached to the flared neck member; a secondary member, further comprising a primary shaft portion and enlarged cone portion, and a rear handle portion, with the outer diameter of the cone being of substantially the same diameter as the inner diameter of the shaft member, so that upon being inserted into the shaft member the cone would protrude out from the shaft member and serve as a means for directing the shaft into the female urethra opening thus eliminating the blunt end of the shaft making contact therewith.

Abstract: The present invention is an apparatus for performing medical examinations in body cavities, and a method of performing such examinations. The apparatus has a chemiluminescent light source having particular wavelength characteristics made up of blue and green wavelengths, and preferably a smaller peak of red light. The apparatus permits improved screening of the mucosal surfaces of body cavities such as the vaginal, anal and oral cavities for a number of abnormalities including lesions, atypia, dysplasia, abnormal vascularization and abnormal discharge. The method of performing examinations using the apparatus is also described.

Abstract: The invention relates to a instrument for laparoscopic surgery which permits the operating surgeon to irrigate or suction the operative area while performing electrocautery or laser hemostasis and dissection of body tissue with the same instrument.The invention also relates to a laparoscopic tool for evacuating free stones or blood clots from the operating area which are to large to be suctioned from the body cavity or to remove gallstones from a gallbladder which has been distended by stones and cannot be retrieved through an umbillical sheath.

Abstract: A method and apparatus is disclosed for the instant intraoperative detection and biopsy of metastatic cancer using fluorescence spectroscopy. A photosensitizing agent selectively retained by cancerous tissue is administered prior to surgery. A fiberoptic probe integrated with a biopsy device illuminates the examined tissue and causes fluorescence which is recorded by a spectrograph and plotted as a spectral curve. The intensity ratio (S1/S2) for the fluorescence from the photosensitizing agent (S1) and autofluorescence (S2) for the examined tissue is compared with the intensity ratio at the same wavelengths for primary tumor and normal tissue. Tissue that displays an intensity ratio different from that of normal tissue can immediately be analyzed for the depth of tumor involvement and then excised for histological examination using the biopsy device.

Abstract: In one method for performing a laparoscopic lumbar discectomy an incision is created in the abdominal wall of a patient. The peritoneal lining is dissected from the abdominal wall while relocating the peritoneal lining toward the midline of the abdomen to create an expanded retroperitoneal space. A surgical apparatus is inserted into the incision comprising an endoscope and surgical means suitable for performing a lumbar discectomy. The surgical apparatus is directed through the expanded retroperitoneal space until the surgical apparatus approaches the anterior aspect of a vertebral body and a discectomy is performed on the vertebral body.

Abstract: A resectoscope and a method of use for removing organic tissue, e.g., the prostate gland, from the body of a living being. The resectoscope includes an elongated member having a distal end adapted to be introduced into the body of the being at the situs of organic tissue to be removed via a tubular sheath. The resectoscope includes a laser for producing a laser beam adjacent the distal end of the elongated member to penetrate several millimeters through the surface of the tissue to coagulate. A rotatable cutter, e.g., a pair of angled offset planar blades, is disposed at the distal end of the elongated member and is arranged to be rotated at a high rate of speed by an associated drive assembly to cut the coagulated tissue. A lumen is provided to carry an irrigation liquid to the situs of the tissue. A suction lumen is provided to carry the tissue removed by the cutter so that it can be retrieved for histological examination.

Abstract: A beam delivery apparatus, including a set of focusing mirrors (or transmissive lenses) mounted along an endoscope channel. A laser beam can be focused into an input end of the channel with a smaller F number (wider cone angle) than is possible in a conventional endoscope. As the beam propagates down the channel, it is reflected (or transmitted) a finite number of times by the focusing elements. The focusing elements act as a periscope to focus and refocus the beam as it propagates along the channel, with little loss of beam power. The invention enables delivery of the beam to the channel's distal end with a smaller F number than can be achieved using a conventional endoscope. In a preferred embodiment, a pair of reflecting strips are mounted the channel, the surface of each strip defines six focusing mirrors, and the beam undergoes a total of twelve reflections from the mirrors as it propagates down the channel.

Abstract: A lens exchanger for a laser surgical tool is disclosed. This lens exchanger installs easily between the coupler for the laser source and the surgical tool (such as a laparoscope). The lens exchanger protects the lens on the surgical tool from contamination by water vapor, smoke and debris. The lens exchanger can be configured to provide clear windows so the surgeon can conveniently switch to a clean lens during surgery as needed. The lens exchanger can also be configured with lenses that change the focus of the laser cutting beam, making the cutting spot more or less focused as required by the particular application.

Abstract: A fiber optic probe is disclosed for delivering laser radiation from a medical laser system to a treatment site. The probe includes a handpiece having an axial channel. The axial channel includes an intermediate mating region of reduced diameter. A tip piece having a fiber located therein is mounted on the front end of the handpiece. The input end of the fiber is mounted in a ferrule which is received in the reduced diameter mating region of the handpiece. A tail piece which includes an optical fiber is mounted at the rear end of the handpiece. The delivery end of the fiber in the tail piece is mounted in a ferrule and is also received in the mating region of the handpiece. The two ferrules are spring biased together to maximize coupling efficiency.

Abstract: A method of creating an aortico-pulmonary shunt with a catheter is provided.

Abstract: A method for distinguishing between calcified atherosclerotic tissue and either fibrous atherosclerotic tissue or normal cardiovascular tissue. The present method is based on the discovery that, when irradiated with a beam of monochromatic infrared light, calcified atherosclerotic human aortic tissue produces a Fourier Transform Raman spectrum which is distinguishable from analagous spectra obtained from fibrous atherosclerotic human aortic tissue and normal human aortic tissue. Some salient differences in the respective Raman spectra are the presence of five Raman bands at Raman shifts of 957, 1071, 1262-1300, 1445, and 1659 cm.sup.-1 (.+-.4 cm.sup.-1 for all shifts) for the calcified tissue as compared to three Raman bands at Raman shifts of 1247-1270, 1453 and 1659 cm.sup.-1 (.+-.4 cm.sup.-1 for all shifts) for the fibrous tissue and three Raman bands at Raman shifts of 1247-1270, 1449 and 1651 cm.sup.-1 (.+-.4 cm.sup.-1 for all shifts) for the normal tissue.

Abstract: The present invention involves a medical delivery system capable of emitting radiation with wavelengths between 190 nm and 16 um in one or more essentially directed, predetermined patterns. It includes at least one solid optical fiber, having a core and a cladding on the core. The cladding has a refractive index smaller than the core, having an input end suitably configured to connect to an appropriate radiation source and having a distal end in the proximity of which two or more grooves are penetrating into the core. The gooves have at least partial reflector capability so as to deflect radiation thereto radially in one or more predetermined patterns. The invention also includes methods of performing medical procedures utilizing the aforesaid device.

Abstract: A method and apparatus for highly localized treatment of biological tissue by a laser includes a micropipette having a tip with a central opening having a diameter of less than about 10 microns. The micropipette is mounted on an articulated arm for precision motion with respect to tissue to be treated. Gas is supplied to the micropipette to prevent the entry of liquid, and laser light supplied through the articulated arm is directed into the pipette. The pipette is positioned in X, Y and Z directions with respect to the tissue to control the location and depth of treatment.A protective window may be positioned at the tip of the micropipette to prevent the entry of liquid.

Abstract: A disposable fiber diverter probe is provided that eliminates many of the typical problems associated with conventional fiber diverter probes that are designed to be used multiple times and must be sterilized between each use. The present invention utilizes thermoplastic materials in many of the components that traditional designs require to be made of metal in order to perform the required functions of a fiber diverter probe. The improved design of the present invention enables less complex, low cost parts to be used in a fiber diverter probe, wherein the probe still provides expanded capabilities over conventional, more expensive fiber diverter probes, such as more accessible and user-friendly controls for the surgeon. Moreover, the reduced cost of the fiber diverter probe provided by the present invention enables a medical facility or a private physician to make disposable fiber diverter probes economically feasible, thus eliminating the risk of exposing patients to a contaminated probe.

Abstract: A laser catheter for irradiation of human myocardial tissue containing a fixed feedback mechanism for monitoring the damage created by laser irradiation, and which is usable with standard catheters designed for angiography and angioplasty. Means for sensing distal temperature are provided in the form of a plurality of thermocouples, along with the ability to cool the fiber optic and distal tip with a flushing solution. Flushing of the area adjacent to the tip is provided for by a fluid which travels the length of the laser catheter. A dissolvable tip covering at the distal end facilitates passage of a very sharp point through a guiding catheter or vasculature.

Abstract: An apparatus for removing dental enamel and dentin. This apparatus is also capable of cutting soft tissue. The apparatus includes a laser which, when activated, produces a laser pulse having a wavelength of between 1.5 and 3.5 microns, a beam diameter at the target site in the range of 10 to 5,000 microns, a pulse duration of between several picoseconds and several milliseconds, an energy level of between 0.1 millijoules and five joules per pulse, and pulse repetition rates from one pulse per second to 10,000 pulses per second. The pulse is focussed on the dental enamel or dentin thereby reaching high enough energy densities to vaporize the material. In the case of soft tissues, a special tip is used to concentrate the laser on the tissue so that cutting action can be easily executed.

Abstract: A midinfrared laser tissue ablater having an Er:YAG radiation source optically connected to a first end of a fiber optic cable, a probe with a handle and a bifurcated cannula having a first half and a second half and a generally closed, hollow tip having an opening opposite the handle, a fiber optic integrally and coaxially mounted in the probe, optically and mechanically connected to a second end of the fiber optic cable and terminating at a free end in an interior of the hollow tip, the free end having a coating with a hole so that a pulse of radiation emitted by the radiation source is directed through the fiber optic cable and the fiber optic to the free end where the pulse of radiation is reflected by the coating out the hole in the coating and into the opening in the tip, an irrigation source connected to the first half of the cannula and an aspiration source connected to the second half of the cannula.

Abstract: An apparatus and method are disclosed for transmitting laser energy to occlusions within obstructed vessels. In the preferred embodiments, a laser delivery catheter includes a hollow tip that encloses a laser energy optical fiber and retractable endoscope. In use, the hollow tip is first positioned adjacent an occlusion. The endoscope can then be retracted within the hollow tip to enhance utilization of the internal volume of the hollow tip for positioning of the laser energy optical fiber, thereby allowing targeting of the occlusion substantially beyond a cross-sectional area of the hollow tip. In a "balloon" embodiment, the position of the laser energy optical fiber is adjusted by an inflatable balloon, adjacent the optical fiber, within the hollow tip. In a "wire" embodiment, the position of the optical fiber is adjusted by a longitudinal movement of a torque wire.

Abstract: An apparatus and method for venting off a surgical laser smoke plume which is generated when body tissue is treated by an optical fiber lasering device, comprising an elongated hollow needle through which an optical fiber laser member extends for emitting a laser beam at the tip of the needle which is adjacent to the body tissue to be treated. A vent side arm has one end which is attached to the needle, and another end which is connected to a suction device, so that when body tissue is treated by the laser beam emitted at the needle tip, the resulting smoke plume that is created will be suctioned up into the channel between the optical fiber strand and the inner surface of the needle and out the vent side arm into the suction device. An O-ring is attached at the outer end of the needle so that any surgical laser smoke plume that is being suctioned out does not escape into the atmosphere or back to the laser generator, but also goes out the vent side arm and into the suction device.

Abstract: A surgical instrument for use in penetrating and working in the vitreous humor of an eye comprises a finger grip member and a rigid needle extending from the finger grip member, with a single continuous fiber optic member extending from a distal end of the needle through the needle and the finger grip member to a cone shaped proximal end contained in a large connecting member constructed of heat conductive material. The surgical instrument includes a stripping tool at its distal end that is bent at a right angle and positioned in a plane that is parallel to the longitudinal axis of the needle but does not intersect this axis. The surgical instrument also comprises an infusion/aspiration system including a hollow pipe attached to the needle that extends parallel to the longitudinal axis of the needle but does not interfere with a beam of light projected from the distal end of the fiber optic member extending through the needle.

Abstract: A catheter for percutaneous surgery of blood vessels and organs using radiant energy, such as laser or radiofrequency radiation is provided, preferably for percutaneous valvotomy and for incision of membranous obstructions in vessels and hollow organs, especially in cardiac cavities. The catheter contains at least one light conductor, such as a waveguide, for EKG timed transmission of the energy radiation from its source to the point of emission of the radiation close to the distal end of the catheter. The EKG times and triggers the pulses of radiation when a heart valve is in the open position of a heartbeat. The catheter has a positioning mechanism so that the distal end of the catheter can anchor reversably and removably in a form fitting manner on a vessel or hollow organ part. The catheter protrudes into the lumen of the vessel or hollow organ part while leaving a throughput opening.

Abstract: A catheter for ablating obstructing material within a corporal lumen includes a fiber optic member through which radiant energy can be transmitted to a distal end adjacent the site of the obstructing material. Beveled surfaces carried on the distal end of the fiber optic member provide output beams of radiant energy oriented in a direction on the order of 45.degree. with respect to an axis of the member. The laterally deflected radiant energy beams impinge upon regions of plaque or obstructing material in the lumen and have an effective radius greater than the radius of the fiber optic member. By rotating the fiber optic member, a circular locus within the lumen can be ablated or vaporized to create a channel in the lumen with a diameter greater than the diameter of the fiber optic member.

Abstract: The present invention is an apparatus for performing medical examinations in body cavities, and a method of performing such examinations. The apparatus has a chemiluminescent light source having particular wavelength characteristics made up of blue and green wavelengths, and preferably a smaller peak of red light. The apparatus permits improved screening of the mucosal surfaces of body cavities such as the vaginal, anal and oral cavities for a number of abnormalities including lesions, atypia, dysplasia, abnormal vascularization and abnormal discharge. The method of performing examinations using the apparatus is also described.

Abstract: A system is described for the delivery of light to, and/or the receiving of light from, a target located on the wall of a tortuous tube such as a blood vessel. The delivery system is generally useful for laterally delivering and receiving light for the detection and photodynamic therapy of target tissue and is particularly useful for the treatment of atherosclerosis. When certain biocompatible photoreactive molecules such as hematoporphyrin or the like are injected into a patient the molecules are selectively taken up by target tissue such as tumors or atheromatous plaque. Subsequent illumination of the target tissue activates the photoreactive molecules causing fluorescence emission from, and destruction of, the host target tissue. The preferred embodiments comprise a hollow optical waveguide terminating in a supple diffuser tip which may be inserted over an intravascular flexible guide wire. The optical delivery catheter is advanced along the guidewire until the diffuser tip reaches the target tissue.

Abstract: Apparatus and method for locally generating hyperthermia-induced coagulation necrosis in tissue masses located deeply within the body of a subject. High energy laser radiation is introduced into the target tissue mass using an optical fiber inserted into a metallic cannula through which a suitable fluid is coaxially flowed. A combination of the fluid flow and the slow withdrawal of the cannula/fiber combination during therapy protects the optical fiber tip, thereby preserving its energy transmission characteristics. After establishment of a small fluid bolus in front of the fiber tip, fluid flow which is approximately proportionate to the laser energy employed has been found to be most effective in this regard.

Abstract: Method and apparatus for tissue cutting and cauterizing using a YAG laser and an optical fiber. YAG laser outputs at wavelengths of 1.06 and 1.3 microns are used for tissue cauterizing and cutting, respectively. In one embodiment, a multimode laser with means for switching the laser output between the two wavelengths is utilized; in another embodiment, individual lasers operating at the respective wavelengths are utilized.

Abstract: A heart-synchronized pulsed laser system includes a laser; a device for sensing the contraction and expansion of a beating heart to be synchronized with the laser; a device, responsive to the device for sensing, for generating a trigger pulse; a control for positioning the leading edge of the trigger pulse during the contraction and expansion cycle of the heartbeat; a control for defining the width of the trigger pulse to occur during the heartbeat cycle; and a circuit responsive to the trigger pulse for firing the laser to strike the beating heart at the time indicated by the trigger pulse position and for the period indicated by the width of the trigger pulse.