Abstract: An improved system for safe and efficient generation of plasmas and vapors bubbles with continuous wave radiations and low levels of power densities, sufficient to treat medical pathologies and to avoid the creation damage to healthy tissue is provided. Transmission means in different configurations are used to achieve a high absorption in water, which is able to initiate plasma with low levels of power density. Once plasma and vapor bubbles are formed, they absorb other wavelengths in addition to the one that initiated it. Other wavelengths, more efficiently generated by diodes or diode pumped lasers, are added into the beam to improve treatment efficiency. This modulated plasma produces fast tissue ablation and good hemostasis effect with minimal overheating of remaining tissue. After plasma and high-energy vapors are generated, only laser radiation that passes through the plasma bubble directly interacts with soft tissues.

Abstract: A method and device for cosmetic surgery, especially fat reduction and collagen reformation, by means of a high power laser operating at about 980 nm is presented. The cosmetic surgery method substantially reduces or removes localized lipodystrophies, and essentially reduces flaccidity by localized laser heating of adipose tissue using an optical fiber inserted into a treatment area. The method and device are particularly well suited for treating Lipodystrophies with flaccidity High power laser energy is applied to “fat” cells to breakdown the cell walls releasing the cell fluid. The laser radiation is applied through an optical fiber which is held within a catheter-like device having a single lumen. Traditionally difficult fat cells are treated well. Delicate areas are treated safely. A saline solution may also be inserted into the treatment site to aid in the heating of the fat cells and their eventual destruction as well as their removal.

Abstract: In one embodiment, an apparatus may include a first capillary component. A second capillary component may be disposed outside of the first capillary component and may have an inner surface, wherein a portion of the inner surface may be heat-fused to an outer surface of the first capillary component. The apparatus may also include a portion of an optical fiber disposed inside of the first capillary component and the portion of the optical fiber can have an outer surface. A portion of the outer surface of the optical fiber may be heat-fused to an inner surface of the first capillary component. The optical fiber may have a distal surface configured to reflect electromagnetic radiation propagated along a longitudinal axis of a distal end portion of the optical fiber in a lateral direction through the inner surface of the first capillary component and the inner surface of the second capillary component.

Abstract: An apparatus for medical treatment by means of laser light includes an optical conducting fiber which has a curved light emission end and includes a core, a cladding arranged above the core for conducting laser light coupled into the optical conducting fiber, and capillaries arranged in the cladding, wherein the capillaries run in a longitudinal direction of the optical conducting fiber at a radial distance from a longitudinal axis of the optical conducting fiber and form a capillary ring when viewed in cross-section, wherein the capillaries have cavities which are separated by bridges which have a width which is smaller than a wavelength of the laser light, wherein the laser light emerges from a forward surface of the light emission end and is transmitted in a direction which runs transverse to a substantially straight longitudinal section located directly in front of a curvature which defines the curved light emission end.

Abstract: A light emitting device, comprises: a light source that emits excitation light; a light guide that propagates the excitation light, and in which the refractive index of the center part (core) of a cross section is higher than the refractive index of the peripheral part (cladding); a wavelength conversion member that absorbs the excitation light propagated by the light guide and converts the wavelength thereof, and releases light of a predetermined wavelength band; and a shielding member that blocks the wavelength of at least part of the excitation light and the light emitted from the wavelength conversion member.

Abstract: An endovascular laser treatment device designed to be used with an optical fiber to treat venous diseases such as varicose veins is provided. The device includes a spacer that positions the distal end of the optical fiber away from the inner wall of the blood vessel during delivery of laser energy to provide an even distribution of thermal energy around the vessel, thereby avoiding vessel perforation and incomplete vessel collapse.

Abstract: A surgical endoscopic cutting device includes cutting elements fitted in a protective tube. The device has an inlet for fluid, a discharge outlet for tissue and fluid, and a further outlet that discharges most of the fluid.

Abstract: A Minimally Invasive Surgical Laser Hand-piece (“MISLH”) for use with a probe is described. The MISLH has a MISLH proximal end and MISLH distal end, and the MISLH may include an optical coupler located at the MISLH proximal end, a substantially straight central bore within the MISLH, and an internal beam stop aperture within the central bore adjoined to the optical coupler. The central bore may extend from the optical coupler to the MISLH distal end and the central bore may be configured to accept the insertion of the probe within the central bore at the MISLH distal end. Additionally, the central bore may be configured to accept the insertion of the probe such that the probe is adjoined to the internal beam stop aperture.

Abstract: In one aspect, a seismic data acquisition unit is disclosed including a closed housing containing: a seismic sensor; a processor operatively coupled to the seismic sensor; a memory operatively coupled to the processor to record seismic data from the sensor; and a power source configured to power the sensor, processor and memory. The sensor, processor, memory and power source are configured to be assemble as an operable unit in the absence of the closed housing.

Abstract: A surgical system includes an external anchor, an internal anchor and an instrument. The external anchor is adapted to be positioned outside a body. The internal anchor is adapted to be inserted into the body via a single entrance port, positioned inside the body and magnetically coupled with the external anchor. The instrument is adapted to be inserted into the body via the single entrance port and secured to the internal anchor. The instrument includes an end-effector that has multiple degrees of movement via multiple axes.

Abstract: In one embodiment, an apparatus includes an optical fiber made of a silica-based material. A proximal end portion of the optical fiber has an outer-layer portion. The proximal end portion can be included in at least a portion of a launch connector configured to receive electromagnetic radiation. The apparatus also includes a component that has a bore therethrough and can be made of a doped silica material. The bore can have an inner-layer portion heat-fused to the outer-layer portion of the optical fiber. The component can also have an index of refraction lower than an index of refraction associated with the outer-layer portion of the optical fiber.

Abstract: An improved method and device for safe and efficient medical applications is provided. In a preferred embodiment, based on using the inherent benefits of laser diodes (such as efficient power generation from a reliable and compact solid state device), plasmas and high energy vapors are produced for medical applications with power levels and power densities sufficient to treat medical indications and avoid the creation of extensive damage zones. Transmissions means in different configurations are used to achieve a high power density, which is able to initiate plasma and high-energy vapor at the tip. Once a sparkless plasma and high energy vapor bubbles are formed, it is often found that it will also absorb other wavelengths in addition to the one that initiated it. As a consequence, other wavelengths more efficiently generated by diodes or diode pumped lasers may be added into the beam in order to improve treatment efficiency.

Abstract: An endovascular sheath device for use with a thermal treatment apparatus is provided. The device includes a longitudinal tube which is designed to receive a thermal treatment device and is designed to be inserted into a blood vessel. An ultrasonically visible reinforcement element is disposed along the length of the longitudinal tube. The reinforcement element such as a braided wire provides several functions including increased visibility under ultrasound, clearer identification of sheath tip, and increased durability to protect the fiber from needle punctures during tumescent injections into the perivenous space. The wire reinforcement also increases shaft torquability and kink resistance during sheath insertion and withdrawal.

Abstract: Methods and devices are disclosed that, in various embodiments and permutations and combinations of inventions, diagnose and treat Pulmonary Embolism or associated symptoms. In one series of embodiments, the invention consists of methods and devices for identifying patients whose Pulmonary Embolism or associated symptoms are caused or exacerbated, at least in part, by blockages of one or more of the patient's internal pulmonary veins. In some instances, stenoses or other flow limiting structures or lesions in the patient's affected veins are identified. Further, in some instances the nature of such lesions and whether there is a significant disruption of blood pressure, or both, is ascertained. In some embodiments, methods and devices for applying one or more therapies to the blockages in the patient's pulmonary veins are provided.

Abstract: A diagnostic catheter and method of use for analyzing tissue is provided. A method for analyzing tissue in accordance with one embodiment of the present invention includes inserting a catheter having a sensor at its distal end into the body of a patient, applying suction through the catheter to secure the tissue to the catheter and then analyzing the tissue with the sensor. An apparatus for analyzing tissue within the body of a patient in accordance with an alternative embodiment of the present invention is also provided. This alternative embodiment includes a catheter having a first end and a second end, the first end having an orifice and a sensor, the catheter also having a lumen.

Abstract: This invention provides a catheter used for blocking abnormal conduction in the cardiac muscle using photodynamic therapy or treating arrhythmia and a method for evaluating the therapeutic effects of the catheter. The catheter has a structure that freely bends at its end, which is used for performing photodynamic ablation of cardiac muscle tissue via photochemical reactions in the blood vessel or cardiac lumen. The catheter comprises a light-emitting window for applying a light beam transmitted through an optical fiber to a target site of cardiac muscle tissue and at least two electrodes for potential measurement in the periphery of the light-emitting window.

Abstract: An apparatus may include an optical fiber having an angled grating aligned along a plane non-normal to a longitudinal axis of a distal end portion of the optical fiber. The angled grating may be configured to redirect a first laser energy propagated within the optical fiber and incident on the angled grating to a direction offset from the longitudinal axis. The apparatus may also include a metallic cap coupled to the optical fiber. The metallic cap may have an inner surface configured to redirect a second laser energy incident on the inner surface along the direction offset from the longitudinal axis. The second laser energy being different than the first laser energy.

Abstract: A waveguide neural interface device including: a neural device implantable in tissue and including an array of electrode sites that electrically communicate with their surroundings, in which the array of electrode sites includes at least one recording electrode site; and a waveguide, coupled to the neural device, that carries light along a longitudinal axis and includes a light directing element that redirects the carried light from the waveguide to illuminate selectively targeted tissue, in which at least a portion of the redirected light is directed laterally away from the longitudinal axis and the recording electrode site is configured to sample illuminated tissue. A method for assembling a waveguide neural interface device is also described.

Abstract: A protective sheath of the type used to protect a scope during insertion of a fiber into the scope may include holes for improved fluid flow and for ease of sterilization, reinforcement, a luer connector to position the sheath relative to a scope and to enable use of a seal, pin vise or other device to secure the fiber to sheath during insertion or withdrawal of the sheath from the scope, and/or markings to facilitate positioning of the sheath relative to the scope and/or trimming of the fiber.

Abstract: An endovascular treatment method for causing closure of a blood vessel is provided. The method includes inserting into a blood vessel an optical fiber having a core through which a laser light travels and a spacer sleeve arranged around a distal portion of the core. A distal end of the core defines an enlarged light emitting face, which advantageously provides substantially lower power density while providing the same amount of total energy during a treatment session. After the insertion, laser light is applied through the light emitting face while the inserted optical fiber and spacer sleeve are longitudinally moved. The spacer sleeve positions the light emitting face away from an inner wall of the blood vessel and application of the laser light causes closure of the blood vessel.

Abstract: An endovascular laser treatment device for causing closure of a blood vessel uses an optical fiber adapted to be inserted into a blood vessel. An inner sleeve is arranged around a distal portion of the optical fiber core such that both distal ends of the inner sleeve and the optical fiber core form an enlarged light emitting face. The enlarged emitting face provides substantially lower power density while providing the same amount of total energy during a treatment session. An outer sleeve arranged around the inner sleeve acts as a spacer to position the light emitting face away from an inner wall of the blood vessel. The enlarged light emitting face and the outer sleeve acting as a spacer reduces the possibility of thermal run-away and device damage, and reduce the possibility of vessel perforations, leading to less bruising, post-operative pain and other clinical complications.

Abstract: A method and an apparatus according to an embodiment of the invention includes a reflector and an optical fiber end portion disposed within a capillary for use in side-firing optical fibers. The reflector surface can be coated with a multilayer dielectric coating to increase the amount of side-fired laser energy. An outer member or cap can be used to protect the capillary when being inserted through a catheter or endoscope. The endoscope is then at least partially inserted into a patient's body to provide laser-based medical treatment. Multiple grooves can be defined on an outer surface of the optical fiber buffer layer to increase the surface area and improve the mechanical strength of the coupling between the optical fiber and the capillary. In some embodiments, the outer member or cap can also be coupled to the grooved surface portion of the optical fiber buffer layer.

Abstract: An endovascular laser treatment device designed to be used with an optical fiber to treat venous diseases such as varicose veins is provided. The device includes a spacer that positions the distal end of the optical fiber away from the inner wall of the blood vessel during delivery of laser energy to provide an even distribution of thermal energy around the vessel, thereby avoiding vessel perforation and incomplete vessel collapse.

Abstract: A method and structure for terminating an optical fiber are disclosed that provide an optical fiber termination structure with a small volume and very low return loss, even when the termination is in close proximity to reflective surfaces. In one example embodiment, the optical fiber termination reduces reflections into the one or more cores to a return loss of ?70 dB or less regardless of the presence of surfaces proximate the optical fiber termination. At the same time, a length of the optical fiber termination is less than 5 mm and a largest transverse dimension of the optical fiber termination is less than 325 um. The optical fiber termination is useful in fiber sensing applications in general and is particularly effective for terminating a multi-core fiber used in a distributed shape sensing application.

Abstract: A steerable laser probe may include a handle having a handle proximal end and a handle distal end, an actuation structure of the handle, a housing sleeve, a shape memory sleeve at least partially disposed within the housing sleeve, and an optic fiber disposed within the shape memory sleeve and within an inner bore of the handle. A compression of the actuation structure may be configured to gradually curve the optic fiber. A compression of the actuation structure may be configured to gradually straighten the optic fiber. A decompression of the actuation structure may be configured to gradually curve the optic fiber. A decompression of the actuation structure may be configured to gradually straighten the optic fiber.

Abstract: The present disclosure relates to a surgical aimer including a shaft having a proximal portion and a distal portion and a handle coupled to the proximal portion of the shaft. The handle includes a mechanism for coupling the shaft to the handle and releasing the shaft from the handle.

Abstract: A laser catheter assembly is provided that includes a plurality of laser active fibers, each fiber having a substantially non-circular fiber cross-section.

Abstract: Methods and devices for separating an implanted object, such as a lead for a mechanical pacemaker or a cardioverter defibrillator, from tissue surrounding such object in a patient's vasculature system. The methods and devices comprise a means for applying tension to the object at the working end of a catheter to reduce the catheter's likelihood of bending or kinking the lead during extraction.

Abstract: Catheter devices for ablation and removal of occlusions from blood vessels and methods of using the same are provided. Catheter devices are useful to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. Distal features of the catheter devices comprise arrangements of laser ablative or mechanical cutting features that generally provide enhanced surface areas and cutting functions. Spiral or helical arrangements are provided to aid in cutting operations.

Abstract: An ablation cannula kit with insert includes a trocar and cannula with a hollow shaft. The hollow shaft is configured to permit passage of the trocar therethrough. An auxiliary port extends from an exterior surface of the cannula and defines a hollow passageway into the hollow shaft. Notably, an insert is included in the kit. The insert defines a hollow shaft and is adapted to be inserted into the hollow shaft of the cannula. An auxiliary port extends from an exterior surface of the insert defining a hollow passageway into the hollow shaft of the insert. Finally, a laser fiber is included with a diameter less than an interior diameter of the hollow shaft of the insert so as to permit passage of the fiber through the hollow shaft of the insert.

Abstract: Laser emission systems for surgical and other therapeutic uses are herein disclosed. In the preferred embodiments, different laser control systems are disclosed and disposable tips and fiber with a unique connection structure are utilized. By being disposable, the tips are manufactured to minimize material loss while also providing the confidence patients desire for their health which comes from knowing the tips are sterile. One end of the fiber is encased in a ferrule, which provides the permanent connection. A lens structure may also be utilized to focus laser light as it passes from a waveguide into the tip. The laser generation module may emit laser light in multiple wavelengths simultaneously and may also feature remote operation.

Abstract: The invention relates to a system for medicinal treatment, in particular for treating benign prostatic hyperplasia BPH, for use in the event of tumor resection or for use in thoracic surgery. The system comprises a diode laser device for producing a laser beam and to an application system based on optical wave guides that can be endoscopically introduced into a patient. Said system is designed in such a manner that the laser beam, produced by the diode laser device is guided through the application system and is emitted by said application system so that biological tissue can be treated in a selective manner with the emerging laser beam.

Abstract: A gradual ramp-up of output power in a medical laser prevents rapid temperature rise at a fiber tip of a laser handpiece when residual contamination from a prior medical procedure remains on the fiber tip after an extended cooling period. The gradual ramp-up eliminates effects of an acoustic shock wave resulting from the rapid temperature rise to prevent damage to fiber and optical components in the laser device.

Abstract: Some implementations provide an apparatus for percutaneous delivery of laser energy, the apparatus including two or more hollow spikes, each having an insertion end and a coupling end, each including an optical fiber embedded as a permanent fixture therein, each optical fiber capable of emitting laser from the insertion end of the corresponding hollow spike; and \a hub coupled to the two or more hollow spikes at the respective coupling ends of each hollow spike, the hub including a connector for coupling the apparatus to a laser generator.

Abstract: Methods and systems for modifying tissue use a pressurized fluid stream carrying coherent light energy. The methods and systems may be used for resecting and debulking soft and hard biological tissues. The coherent light is focused within a stream of fluid to deliver energy to the tissue to be treated.

Abstract: An ablation catheter includes an elongated sheath configured for intravascular usage, and an inner tube disposed within the elongated sheath. The inner tube is rotatable and translatable relative to the sheath. An optical fiber is disposed within the inner tube and extends longitudinally therethrough. A proximal end of the optical fiber is optically coupled to a light source and a distal end of the optical fiber is connected to a beam director configured to focus energy on target tissue inside a blood vessel to ablate the target tissue.

Abstract: A method for photoselective vaporization of prostate tissue includes delivering laser radiation to the treatment area on the tissue, via an optical fiber for example, wherein the laser radiation has a wavelength and irradiance in the treatment area on the surface of the tissue sufficient because vaporization of a substantially greater volume of tissue than a volume of residual coagulated tissue caused by the laser radiation. The laser radiation is generated using a neodymium doped solid-state laser, including optics producing a second or higher harmonic output with greater than 60 watts average output power. The delivered laser radiation has a wavelength for example in a range of about 200 nm to about 650 nm, and has an average irradiance in the treatment area greater than about 10 kilowatts/cm2, in a spot size of at least 0.05 mm2.

Abstract: Methods for decreasing the size and/or changing the shape of pelvic tissues. Energy, preferably radio frequency or laser energy, may be applied to endopelvic fascia or other subcutaneous tissue transcutaneously, through one or more incisions in skin, or directly to the desired subcutaneous tissue after a strip of mucosa or skin has been removed. Such an application of energy may cause the subcutaneous tissue to shrink, thereby bringing the mucosa or skin edges closer together while minimizing damage to deep nerves and other surrounding tissues. Such manipulation of the layers of the skin may be utilized to decrease the size or change the shape of numerous anatomical structures and may also serve to alleviate the symptoms of urinary incontinence, dyspareunia, or chronic pelvic pain. The method steps of the present invention may further provide for the beneficial pretreatment of a tissue site prior to stem cell implantation.

Abstract: The laser applicator includes a catheter (10) having a proximal section (10a), a midsection (10b) and a distal end section (10c). It contains a light guide, the light of which is output in a decoupling portion (40). The light guide runs in a longitudinal groove on the outside of a catheter body. While the light guide (20) is continuous, the catheter is composed of catheter bodies, which are joined together at a catheter splice site (37).

Abstract: Embodiments of the invention include an apparatus including an optical fiber having a distal end configured to emit a beam of energy. The apparatus also includes a tube including a tube channel. The distal end of the optical fiber is disposed in the tube channel. The apparatus further includes a shock absorber disposed on the tube and a cap disposed on the shock absorber.

Abstract: An apparatus and a method are provided for the treatment of soft tissue. The apparatus includes a light source and at least two optical assemblies. Each of the optical assemblies includes at least one optical element and a light-transmitting contact surface configured to transmit a substantially uniform distribution of light therethrough. The apparatus further includes at least two optical transmission devices each disposed between the light source and a corresponding one of the at least two optical assemblies. The apparatus also includes a handpiece to which the at least two optical assemblies are attached, and which is adapted to bring the light-transmitting contact surfaces of the at least two optical assemblies in contact with soft tissue disposed therebetween.

Abstract: In some embodiments, without limitation, the invention comprises a catheter having an elongated housing with a channel disposed therein. A laser delivery member is movable and at least partially disposed within the channel. A ramp is disposed within the housing at an angle to its central axis and proximate to its distal end. The ramp is adapted to move the distal end of the laser delivery member outwardly from the central axis of the housing. A guidewire biases the distal end of the laser delivery member generally inwardly toward the central axis of the housing. In some embodiments, without limitation, the offset of the central axis of the tip of the laser delivery member from the central axis of the housing is determined by adjusting the extent to which the laser delivery member travels on the ramp, and disposition of the laser delivery member on the guidewire maintains the offset tip substantially parallel to the central axis of the housing.

Abstract: An improved procedure for performing liposuction is obtained by utilizing a needle that includes a laser source conductor with one end of the needle being configured for insertion into a target adipose skin volume and the other end being coupled to a laser source. The needle may include one or more channels for extracting the treated adipose area. A vacuum source can be used in the extraction of the treated adipose. Further, the first end of the needle may include a cap or end-piece that reduces the build up of carbon deposits. A temperature sensor may be used as input to adjust the laser power and prevent over exposure.

Abstract: Focused infrared light at wavelengths selected to target tissue below the skin may be used in a non-invasive procedure for vasectomies, varicose veins, hemorrhoids, or fungal nail infections. Infrared light from various sources selected for a particular application may be focused so that the cone of light has lower intensity on the skin/outer tissue and higher intensity at a desired depth to cause thermal coagulation or occlusion of the target tissue beneath the skin. Surface cooling techniques, such as cryogenic sprays or contact cooling may be used to protect the skin. More generally, the focused infrared light with or without surface cooling may be used in applications for thermally coagulating or occluding relatively shallow vessels while protecting or minimizing damage to outer layers of the tissue or skin.

Abstract: Apparatus and systems for tissue dissection and modification are disclosed herein. A method for tissue dissection and modification may comprise inserting a tissue dissecting and modifying wand (TDM) through an incision in a patient's body. The TDM may comprise a modular tip having a plurality of protrusions with lysing segments positioned between the protrusions to dissect and/or modify tissue. The TDM may also comprise an energy window positioned on top of the TDM that is configured to deliver energy via thermochromic means to modify tissues. After separating tissue using the lysing segment(s) to define a target region, the energy window may be activated and moved around within the target region to modify tissues. In some implementations, the energy window may be activated prior to and/or during dissection of the tissue such that the tissue is separated while tissue is modified within the target region.

Abstract: Embodiments of the present invention comprise a fiber optic guidewire having a hypotube with a plurality of openings that provide variable stiffness and tracking characteristics between at least one proximal segment and one distal segment of the guidewire. In some embodiments, the guidewire further comprises a mandrel disposed within the hypotube, the mandrel cooperating with the optical fibers to permit the distal end of the hypotube to be shaped as desired by a user. Methods of manufacturing and using the guidewire are also disclosed.

Abstract: The invention is directed to a laser catheter (1) for bypass surgery, wherein the distal part (2) of the catheter (1) is provided with: a tubular arrangement (3) of optical fibers (4) having distal ends (5) defining a ring-shaped light emergence surface (6) for emitting a tubular bundle of light beams in the distal direction (D) of the catheter (1); and a stop surface (7) extending around the tubular arrangement (3) of optical fibers (4) and facing in the distal direction (D), the stop surface (7) being arranged at a distance (A) proximally from the light emergence surface (6). The light emergence surface (6) slants at a slanting angle (?) in the range of [20°, 60°] with respect to the longitudinal axis (8) of the catheter (1). The invention further relates to an assembly comprising such a catheter.

Abstract: A skin cooling method for a dermatologic treatment procedure, by which a skin target region is exposed for a specified duration to irradiation with electromagnetic energy emitted from an electromagnetic energy exit opening of a skin treatment applicator and the target region is cooled at least during part of the duration of the exposure to electromagnetic energy irradiation, wherein a cooling procedure is performed including an air cooling step comprising ejection of a directional flow of cooling air towards the skin treatment region, said directional cooling air flow having a temperature T in the interval 0° C.<T?15° C. In an apparatus according to the invention this method may be combined with one or more contact cooling steps.

Abstract: Light-source treatment devices such as dermatological or cosmetic devices include a skin contacting surface layer that is antimicrobial. The antimicrobial skin contacting surface layer enhances the cleanliness of the device and helps reduce infection and contamination risks associated with use of the devices, particularly where the treatment of multiple individuals occurs. The antimicrobial layer may be titanium dioxide.

Abstract: The present invention provides devices and methods for modulating or blocking renal sympathetic nerve activity by applying laser energy to the renal artery wall to effect ablation of the renal nerve or nerves. The devices and methods of the invention may be useful in the treatment of cardiovascular and renal disease resulting from hypertension. In addition the devices and methods of the invention may be useful for reducing reflex hypertension following cyclosporine administration after organ transplantation.