Abstract: A probe for medical use includes a tip portion having a light energy input region for receiving light energy from a light source and a predetermined light energy output region whereby tissue subtended by the region may be irradiated by the light energy. The tip portion consists essentially of light propagating material having inclusions distributed therein for interacting with the light energy to produce a predetermined light energy output pattern. The light propagating material is a light propagating inorganic compound.

Abstract: An operating assembly for use in a liquid operating environment includes a flexible elongated light transmitting fiber having a light reflecting tip mounted thereon for reflecting the light beam laterally. The tip includes a number of features which minimize undesired heating of the tip. The tip is preferably made of solid gold and has a reflecting mirror surface coined on the gold tip. A lateral flushing passageway is disposed through the tip and allows surrounding ambient liquid to flow across the surface of the mirror to aid in cooling the tip and to aid in keeping the mirror clean. The tip is preferably mounted on the fiber by crimping.

Abstract: A method for the photodisruption of tissue using a laser beam for stereotactic laser neurosurgery includes the initial step of positioning the distal end of a probe into the tissue to be photodisrupted. A laser beam having laser pulses of picosecond or femtosecond duration is then directed along a beam path through the probe. Using a focusing lens, which is slidably positioned on the beam path in the probe, and a light reflector, which is slidably positioned on the beam path at the distal end of the probe, the laser beam is focused to a focal point that is located on a line substantially perpendicular to the beam path through the probe. By concerted movement of the lens and mirror, predetermined cylindrical layers of tissue can be photodisrupted. Specifically, a rotation of the mirror causes photodisruption of tissue along a circular arc and a simultaneous movement of the lens and mirror allows for photodisruption of additional arcs on a cylindrical surface.

Abstract: The illuminator of the invention takes relatively coherent light exiting from a fiber optic cable and spreads it in an even manner over a wide viewing area of an eye retina, and by securing a transparent ball to face the light output of the fiber optic cable with an air gap in-between, thus allowing a large light index differential between the fiber material and the light refracting material while having the second surface of the ball immersed in vitreous eye fluid.

Abstract: There is provided a side-emitting optical fiber having a proximal end for receiving radiation and a distal end for emitting the radiation in a direction laterally of the longitudinal axis of the fiber via a radiation exit region at the distal end; characterized in that the outer surface of the distal end of the a glass cap is formed with a visually discernible surface formation which is narrow at one end thereof and which increases in width towards the opposite end thereof, to thereby enable visually discerning the orientation of the optical fiber with respect to the radiation exit region thereof.

Abstract: A side firing fiber optic probe is disclosed. The delivery end of the probe is provided with an angled face oriented to totally internally reflect the treatment beam out of the side surface of the fiber in a direction transverse to the longitudinal axis thereof. The delivery end of the probe is further configured to reduce secondary reflections which occur as the light strikes the side surface of the fiber. This result can be achieved by modifying the shape of the cladding material which surrounds the fiber core. In one approach, the ratio of the diameters of the clad to the core is increased. Other specific cladding configurations for reducing reflections can be used. In a further alternative, the surface of a glass capillary which surrounds the fiber can be optically coupled to the fiber. Each of these approaches functions to reduce unwanted light leakage from the fiber.

Abstract: Improved methods and devices related to laser-assisted transmyocardial revascularization (TMR), and more particularly, to improved methods and devices for creating branched TMR channels through myocardium in which a single opening is made in an epicardial surface with a plurality of channel branches, having predetermined geometries extending into and through myocardium, depending therefrom. A method of creating branched TMR channels comprises piercing an epicardial surface mechanically or with laser energy, directing laser energy through the opening in a first predetermined angular orientation with respect to the epicardial surface to create a first channel and delivering laser energy in a second predetermined angular orientation to create a second branch. A plurality of branches can thus be created in a single channel structure.

Abstract: A device for delivering phototherapeutic light to the nipple and surrounding tissue of a breast. Many mastectomy procedures for patients with breast cancer require removal of the nipple. Thus, for the best aesthetic result, post-operative augmentation or reconstruction of the breast includes the implantation of an artificial nipple. The present device and method permits a more conservative mastectomy to be performed while reducing the risk of recurrence wherein cancerous and pre-cancerous tissue in the nipple and surrounding aureole tissue are treated by illuminating the tissue with phototherapeutic light. The tissue is first perfused with a photosensitizer which accumulates therewithin. An embodiment of the device, which includes a rigid or semi-rigid hemispherical shell for structural stability, is attached to the breast. The device includes a transparent flexible aperture which is designed to fit snugly against the outer surface of the nipple and surrounding tissue.

Abstract: A method and device for selective photothermolysis of a surgical target within surrounding tissue. The target and the surrounding tissue are heated to about 60.degree. C. Then the target is heated to the point of coagulation, preferably by monochromatic light. The temperature difference between the coagulating target and the surrounding tissue is sufficiently mild that heat diffusing out of the target does not damage the surrounding tissue, even in the case of a relatively large target such as varicose veins.

Abstract: A diffusing tip is provided for diffusing light from a light-emitting end of an optical fiber in a radial distribution pattern relative to the axis of the tip and along a length of the tip. The tip has an inner core and an outer covering which define a light guide. The outer covering is modified on its interior surface adjacent to the core such that light transmitted down the light guide is removed from the core upon encountering a surface modification on the interior surface. The light so removed is transmitted to the outer surface along the length of the tip, where it can be used to irradiate a selected object or material. The diffusing tip preferably provides light in a substantially uniform intensity distribution for the substantially uniform irradiation of a selected object or material.

Abstract: In a surgical catheter or probe, an array of multiple surgical laser beams are directed such that several laser beams intersect at a precise point on, or in, the body of a surgical patient. The power density of the laser energy of the intersecting beams at the point of intersection is sufficient to alter or ablate the patient's tissue, bone or fluid. The energy of the individual laser beams before or after the point of intersection is not sufficient to injure the body of the patient. The apparatus may be embodied as a catheter or probe for an endoscope, or can be used in a separate mechanism such that the laser beams enter the surgical patient at different locations but intersect at a point within the patient.

Abstract: A laser apparatus for medical treatment use in which a laser beam is irradiated on a portion of a human body to be treated comprises a laser beam generation unit for generating a laser beam of giant pulse, a laser beam guide member having one end through which the laser beam from the laser beam generation unit is guided, and a hand piece attached to another end of the laser beam guide member and irradiating the laser beam to the portion to be treated. A beam converging point is formed within a laser beam propagating path formed in at least one of the light guiding means and the hand piece and a stay of air is prevented from a predetermined region in the laser beam propagating path including at least the beam converging point at which the air stays. The predetermined region is positioned within the hand piece or the laser beam guide member. The air stay is prevented by means of producing a vacuum state, gas seal state or air flow state in the predetermined region.

Abstract: A novel microfocusing laser surgical probe for use in intraocular surgery combines a high power laser with a gradient index (GRIN) lens to provide sufficient energy density at a focal point inside the eye to achieve laser induced breakdown and destroy fibrovascular membranes resulting from diabetes and other diseases. The gradient index lens steeply focuses the light close to its end so that the energy density of the light widely diverges beyond the focal point to reduce the potential for damage to the underlying retina. The gradient index lens also focuses the light far enough from the end of the lens to prevent damage to the lens itself. In a first embodiment, an open transmission line couples a YAG laser to a gradient index lens so that the light is still collimated when it strikes the lens. This first probe may be articulated by the use of mirrors or other optical devices.

Abstract: A dental video camera includes a housing which has an elongated cavity with a distal end and a proximal end, an adjustably focusing lens and CCD camera system which is disposed within the elongated cavity of the housing, a fixed focusing lens system and an adjustable iris. The adjustably focusing lens and CCD camera system provides a focusing adjustment between a near field of focus and a far field of focus. The fixed focusing lens system is optically coupled to the adjustably focusing lens and CCD camera system and is disposed in the elongated cavity of the housing adjacent to the distal end thereof. The adjustable iris is optically and mechanically coupled to the adjustably focusing lens and CCD camera system. The adjustable iris is adjusted between a nearly closed opening and a wide open opening in response to the focusing adjustment between the near field of focus and the far field of focus.

Abstract: An optical fiber device for forming channels within a wall of a patient's heart, and particularly the epicardium, which has an elongated optical fiber, a probe tip secured to the distal end of the optical fiber and an outer support tube secured to the proximal portion of the probe tip and a distal portion of the optical fiber proximal to the probe tip. In another embodiment the optical fiber device has an elongated optical fiber, a probe tip secured to the distal end of the optical fiber and a radiating step or projection on the exterior of the probe tip to act as a stopping surface to control the depth of penetration of the probe tip into tissue.

Abstract: A method for modifying the curvature of a live cornea to correct a patient's vision. First, at least one relatively small opening is made in the cornea for inserting a fiber optic cable or micro-cutting tool therein to create a pocket or cavity with first and second opposed internal surfaces. The laser beam or micro-cutting tool can be directed onto one of the first and second internal surfaces, or both, if needed or desired to incrementally and sequentially ablate or remove three-dimensional portions of the cornea. If a laser beam is used, then a flexible template can be inserted into the opening in the cornea for accurately controlling the pattern to be ablated within the cornea. Preferably, the live cornea is then left alone to collapse and obtain its new refractive power by waiting a set period of time. After waiting the set period of time, the cornea is then examined to determine the new refractive power of the cornea.

Abstract: The method for combined mechanical/laser myocardial revascularization of a human heart includes: inserting a mechanical piercing device and an elongated flexible lasing apparatus into the chest cavity of a patient; mechanically piercing, micro-tearing or spreading the epicardium of the heart; and then lasing from beneath the epicardium through the myocardium.

Abstract: A method for performing concurrent spherical and cylindrical corrections to the corneal surface of the eye to reduce myopia and astigmatism. A laser beam irradiates the corneal surface via a variable diameter iris and a slot produced by a pair of translatable blades. The width of the slot and the diameter of the iris are varied as the laser is pulsed to produce a toric ablation of the corneal surface. Alternatively, the laser beam is passed through a succession of apertures in a tilted variable aperture element to produce toric ablation. The total number of laser pulses required to effect both types of correction is equal to the number required for the spherical correction alone, reducing the laser power and the procedure time. The toric ablation produces no steep end walls as with standard cylindrical ablation procedures, thereby eliminating hyperopic shift and minimizing flattening along the ablated cylinder axis.

Abstract: An apparatus and method for performing a myringotomy in a child's ear without the need for anaesthesia. A charge coupled device or television camera is aimed within a micromanipulator housing at a child's ear drum. The housing is retained to the ear, either with a fastener such as an adhesive or in a helmet, so that the housing moves with the movement of the child's head. A video image of the ear drum surface is displayed on a screen from signals transmitted from the camera device. A physician marks on the screen with an electronic pen pointer where the laser beam should be aimed at the ear drum surface. A microprocessor responds to this marking to determine the appropriate coordinates and instructs mirror control motors to rotate a scanning mirror in the path of the laser beam. The laser may be fired and its beam is directed by the scanning mirror to strike a desired location by passing through the housing attached to the child's ear without being affected by any sudden movement of the child's head.

Abstract: A laser surgery apparatus including a contact tip comprising an input face having a surface for receiving laser energy from an optical waveguide directed along an axis of propagation. The surface is inclined relative to the axis of propagation such that an angle of incidence between the laser light and the surface is approximately equal to Brewster's angle. Another aspect of the invention includes coating a portion of the tip body with a coating that is reflective to the laser energy. One preferred embodiment comprises a tip body coated with a single coating consisting essentially of a material which is biologically compatible with tissue to prevent generation of a toxic tissue response. A further aspect of the invention includes a tip configuration having a generally conical exterior with a substantially flat surface disposed obliquely to a core axis of the tip body.

Abstract: A thoracoscopic transmyocardial revascularization handpiece assembly for a medical laser system which includes a barrel which fits between the patient's ribs, a handpiece which fits between the ribs, a contacting surface on one end of the handpiece with a width which fits between the patient's ribs, and a contacting surface which has a length larger than the width resulting in a contact surface with a surface area which is greater than the cross-sectional area of the handpiece and which yet still fits between the patient's ribs.

Abstract: An endoscopic light delivery system for delivering light to tissue includes a laser source for generating light. Fiber optics encased in a plastic buffer are optically coupled to the laser source for conveying the light generated by the laser source. A tip member secured to the fiber optics positions a mirror adjacent to the light delivery end of the fiber optics. The mirror redirects light conveyed by the fiber optics in a direction lateral to the fiber optics. A heat resistant ring encircling the fiber optics near the light delivery end shields the fiber optics from heat to prevent the plastic buffer near the light delivery end from melting. A lateral extension of the tip member spaces the mirror and fiber optics away from tissue. A band with a circumferential groove encircles the light receiving end of the fiber optics. A connector having a bore is capable of receiving the light receiving end of the fiber optics in the bore and locking the band within the bore by engaging the groove with a locking device.

Abstract: In a laser surgical unit having a contact laser probe (1), a hydroxyl group (13) is included in the contact laser probe so that a laser beam is partially absorbed by the hydroxyl group (13) to heat the contact laser probe (1) for transmission to living tissue. Consequently, a coagulation layer is formed in the living tissue along with vaporization and incision. At least a part of the contact laser probe (1) is made of a material which contains the hydroxyl group (13) generally in an amount of between 0.5 and 10 ppm. Alternatively, the hydroxyl group (13) may be included only in a portion adjacent to a surface of a tip portion of the probe (1). As a further alternative, a coating film containing the hydroxyl group (13) may be attached to the tip of the contact laser probe (1). The laser beam preferably has a wavelength between 1.5 and 15 .mu.m. For example, use is made of an Er:YAG laser beam a Ho:YAG laser beam, or a CO.sub.2 laser beam.

Abstract: A device is provided for identifying certain characteristics of an end piece or end effector of a surgical instrument. A preferred embodiment provides a surgical stapling instrument having an electrical circuit contained on the stapling cartridge which is capable of indicating cartridge type and/or status (i.e., with or without staples) when a voltage or current is applied to the circuit. Other identification means are provided including an optical identification means.

Abstract: The laser surgical applicator according to the invention is used for contact vaporization of tissue and has a light guide with a quartz glass core at whose distal end a contact tip made of an optically transparent solid material is located. The contact tip has a quartz glass sheath in which at least the quartz glass core of the light guide runs coaxially at a distance from the inside wall and the distal end of the quartz glass core is molten with the distal end of the quartz glass sheath to form an optically transparent tip.

Abstract: A laser micromanipulator for surgical applications includes an adaptor attachable to a laser and to a microscope which automatically maintains, preferably using phase detection, the laser beam in focus on tissue during any changes in the working distance by the surgeon manipulating the microscope.

Abstract: A laser surgical apparatus is disclosed in which laser energy can be directed at an angle relative to the longitudinal axis of the probe. The probe includes a reflecting surface directing the laser energy. The reflecting surface is transparent to visible light. In a preferred embodiment, the reflecting surface is on a rod cut at an angle to form a wedge, and a collimator is used to collimate the light beam before it reaches the reflecting surface.

Abstract: A method and apparatus for removing hair is disclosed. The method includes the step of producing at least one pulse of incoherent electromagnetic energy. The incoherent electromagnetic energy is then coupled to an area of surface of the tissue that includes more than one hair follicle. The method may alternatively include the step of applying a gel on a surface of the tissue to cool the tissue. The energy heats the hairs and hair follicles, without heating the tissue. The apparatus includes a source of pulsed incoherent electromagnetic energy. The source is located within a housing, and a coupler directs the incoherent electromagnetic energy to the surface of the tissue. In an alternative arrangement a gel disposed on the surface of the tissue such that the gel cools the tissue but is not adjacent, and does not cool, the hair follicle.

Abstract: An apparatus for removing tissue from the eye performs various types of corrections using a relatively large beam, but oscillated or dithered to prevent the formation of ridges during the removal process. Various types of corrections are contemplated such as hyperopic and astigmatic using a large beam which is scanned over the area to be ablated using overlapping shots which are between 10% and 90% of the area of the total area to be ablated.

Abstract: A surgical illumination probe includes an optical fiber with a proximal end and a distal end, a connector disposed at the proximal end of the optical fiber (the connector being adapted for connection to a source of illumination and for holding the proximal end of the optical fiber in position to accept light from the illumination source), and a handpiece disposed generally at the distal end of the optical fiber. The handpiece has a handpiece body and a needle extending distally from the handpiece body, with the optical fiber extending generally through the handpiece and extending slightly past the distal end of the needle. The handpiece is of a size suitable for one-handed operation by a human user, and the needle is of a size suitable for insertion into a human eye.

Abstract: Method and apparatus for stabilizing a fiber optic relative to the skin surface of a patient so that radiation from the fiber optic strikes a defined surface area on the skin independently of patient movement. The apparatus comprises a polypod support having a fiber optic supporting platform and at least three legs to form a tripod. Each of the legs has two ends, a first of which is secured to the fiber optic supporting platform and the second of which is securely attached to the skin of the patient, either directly or by means of a foot attached to the second end. The method of the present invention comprises attaching a polypod, as above described, to the skin of a patient and irradiating a defined surface area by means of an end of a fiber optic held by the polypod support.

Abstract: A method for joining or restructuring tissue consists essentially of providing a preformed film or sheet of a solid filler material which fuses to tissue upon the application of energy. The material comprises collagen, gelatin, mixtures thereof, optionally combined with a plasticizer, and the film may be cut prior to placing over the tissue. Radiofrequency energy is then applied at between about 20 and 120 Watts to the filler material and the tissue after the filler material has been placed over the tissue for about 1 to 60 seconds so that about 20 to 1800 joules are delivered to the filler material and tissue.

Abstract: An apparatus for use with a laser surgical tool comprises an elongate substantially hollow sheath having a pair of spaced apart axially extending guide members on a distal end and an attaching mechanism on the second end for ready attachment to a laser knife. The attaching mechanism is a grooved surface permitting rotation of the elongate sheath about its longitudinal axis which is coincident with the longitudinal axis of the laser knife. A second attaching mechanism comprises a plurality of circumferentially spaced apart, radially inwardly extending protuberances which matingly engage corresponding dimples on the laser knife preventing rotation of the sheath about the longitudinal axis. For use with laser knives having a bent elongate center portion, the sheath includes a separately rotatable guide sheath tip for rotation of that portion of the sheath between the bend in the elongate center portion of the laser knife and the distal end thereof, including the laser lens.

Abstract: A surgical laser instrument including a transparent, splay, plate-like waveguide including one or more discontinuities therewithin for flattening and expanding a laser beam received through the waveguide and for emitting therefrom a relatively flat laser beam that can be utilized to sweep a selected tissue or region to be treated.

Abstract: A hand held microsurgical instrument for applying laser energy to selected locations (sites) in an area under the skin (or other exposed translucent tissue) to provide localized photothermolysis of underlying tissue at these sites, is described. The laser energy is focused into a spot within the tissue. This spot is of sufficiently small size so that the energy density is sufficient to provide surgical or treatment effects within the tissue without damaging the surface tissue. In dermatology, for example, the technique can be used to destroy endothelial cells in blood vessels which are desired to be removed, such spider veins (nevi) in the skin, hair follicles to prevent hair growth therefrom, or other microsurgical procedures. The area is visualized while the laser beam is steered, using a deflection system, in X and Y coordinates.

Abstract: A fiber optic integrated phacoemulsification system is disclosed comprising surgical handpieces for cataract surgery which incorporate fiber optic bundles that transmit visible light to enhance visualization by intraocular illumination. Patient safety is improved by the oblique lighting to the retina, thereby reducing the necessity of direct coaxial light from the surgical microscope. The fiber optic bundles enable the application of laser energy or visible light and permit endoscope visualization of intraocular structures either through the surgical handpiece or through an end piece attachment.

Abstract: Apparatus and methods to modify the intensity distribution of a beam of radiation, such as a laser, and for eroding surfaces with predetermined shapes. A rotatable mask is formed with one or more apertures that have a geometric spiral shape originating substantially the center of rotation on the mask. The mask is insert to the beam for modification of the intensity of that beam, and additionally to form the desired etch pattern on a target surface. In a preferred embodiment, the invention is useful for performing kerotoplasty or keratomileusis.

Abstract: Phototherapeutic instruments are disclosed having integral stopper devices which limit the penetration of an optical fiber during tissue penetrating phototherapy. In one preferred embodiment, a fluted outer sheath is disposed about an internal optical fiber. The fluted sheath is configured to expand during penetration of the optical fiber into a patient's tissue. As the fluted elements expand, the present a much larger cross-sectional area which resists further penetration of the instrument beyond a predetermined desirable distance. The invention is useful in limiting an optically-transmissive fiber's penetration and, thereby, reduce the possibility of perforation of a body lumen or organ. The invention is particularly useful in placing a ablative laser radiation device into the ventricle of the heart when performing arrhythmia-correcting laser ablative procedures or when revascularizing the heart percutaneously.

Abstract: This invention provides a device and method for perforation of skin for the purpose of drawing blood or administering pharmaceuticals. The device incorporates a laser which produces a laser beam at an appropriate wavelength which is specifically focused to perforate the skin of a patient. Optionally a container can be incorporated in the device for collecion of blood from the perforated tissue.

Abstract: The present invention consists of methods and apparatus for laser ablation of the cornea to correct strabismus. The laser beam is controlled by a system of limiting shutters to cut prism lenses into the cornea. The ablation is to remain substantially within the Bowman's layer, keeping scarring to a minimum.

Abstract: Methods and apparatus are disclosed for diffusing radiation from a optical fiber to provide a larger exposure area for phototherapy and to provide a substantially uniform energy distribution to a major portion of the exposure area. The invention is especially useful in constructing and implementing circumferential and/or sideways-emitting diffusive tip assemblies, or quasi-spherical diffusive tip assemblies for optical fibers to direct laser radiation in a radially outward pattern relative to the fiber's axis. In one aspect of the invention, a plurality of optically-transmissive fiber tip assemblies are employed to act as diffusers. The two or more fiber tip assemblies are deployed as loops which create a uniform illumination pattern. By "looping" or "folding" the fibers, a plurality of fibers can be deployed in conjunction with one another to create geometric exposure patterns with increased energy density while still avoiding "hot spots.

Abstract: An intraocular light probe has a slit-shaped mask or cannula affixed at a distal end thereof which forms a slit-shaped light beam for intraocular slit-illumination of target features within the eye. A hood at a distal tip portion directs light in a particular direction. A distal flange retains the instrument within the eye. In a second embodiment, a light probe for intraocular application of a slit-shaped light beam is created by forming a slit shape at a distal end of an optical fiber bundle. A third embodiment provides a surgical instrument, such as a phacoemulsifier or vitrector, having an infusion sleeve which incorporates a slit illuminator for intraocular application of a slit-shaped light beam to target tissues. The device of the invention is preferably introduced into the eye via the primary or side-port incision to provide intraocular cross-lighting of tissues during surgical procedures such as cataract extraction, vitrectomy, intraocular lens implantation, refractive surgery, and glaucoma surgery.

Abstract: The illuminator of the invention takes relatively coherent light exiting from a fiber optic cable, and disperses it in an even manner over a wide viewing area of an eye retina, and by securing a transparent material having a light dispersing first surface to face the light output end of the fiber optic cable with an air gap in-between, thus allowing a large light index differential between the fiber material and the light dispersing material.

Abstract: A laser treatment device provides an output operating laser beam having a single wavelength which is highly absorbed by tissue of a patient and which beam is non-diverging. The laser treatment device may be a catheter which is inserted into a patient for performing endovascular myocardial revascularization (i.e., creating new channels for blood flow from within the interior of the patient's heart). The use of the highly absorbed wavelength and the non-diverging character of the beam are possible by having a distal laser at a distal end of the catheter. The distal laser is pumped by a source of laser energy supplied by an array of diode lasers and passed along an optical fiber from a proximal end of the catheter.

Abstract: A surgical instrument for treating a blood vessel wall following percutaneous transluminal coronary angioplasty (PTCA) includes an optical system for transmitting radiant energy, preferably UV light energy, from a laser source to the distal end portion a PTCA catheter and causing the radiant energy to exit the catheter in a relatively narrow radial band. A microprocessor-controlled stepping motor is used to longitudinally reposition the band along the length of the balloon of the PTCA catheter to thereby expose endothelial tissue spanned by the balloon to radiation for the purpose of inhibiting smooth muscle proliferation reducing incidences of restenosis.

Abstract: A cage for use in a spinal repair system wherein a pair of inert, relatively open bone-graft contouring cages are disposed between adjacent vertebrae mounted to the boney structure of these vertebrae wherein the vertebrae will knit together and act as a single unit. The upper and lower surfaces of the cages follow an arcuate path for increased contact with the abutting surfaces of the vertebrae themselves.

Abstract: Disclosed is an apparatus for use in applying UV light to a blood vessel wall following the performance of a balloon angioplasty procedure. It comprises an elongated optical fiber whose outside diameter permits it to be inserted into the lumen of a guidewire that is used to position the angioplasty balloon at the site of the lesion to be treated. The guidewire is provided with a light port and a suitable reflector is provided for causing UV light transmitted through the optical fiber to be radiated in a radial direction through the light port in the guidewire to thereby irradiate the vessel wall with UV energy that has been found effective in retarding growth of smooth muscle cells.

Abstract: The surgical tool is used in conjunction with a direct contact laser that is powered through a small diameter laser power tube. In one embodiment, the tool includes a bendable, rigid tube having a lumen sufficiently larger than the laser power tube such that upon application of an axial, inboard directed force, the laser power tube is axially compressed within the lumen of the bendable tube. The contact laser tip, located at the end of the power tube, is powered by a laser core which is retained within the lumen of the laser power tube. The laser core is flooded by irrigation and cooling fluid flowing through the laser power tube. This fluid is ejected or emitted from the distal end of the laser power tube immediately behind the laser contact tip. In one embodiment, the bendable tube includes a handle and a bendable, rigid nozzle made of plastic. A longitudinally actuated suction control valve is disposed in the handle.

Abstract: A method of treating a patient's prostate. An endoscopic instrument is inserted through the patient's urethra such that a distal portion of the endoscopic instrument is inserted into the patient's prostatic urethra and engaged with an interior wall of the prostatic urethra. A laterally transmitting laser fiber tip of a laser fiber is placed in the endoscopic instrument adjacent to a window therein such that the tip is spaced laterally from an area of the interior wall of the prostatic urethra. Laser light energy is transmitted laterally from the tip through the window onto the interior wall for treatment thereof. A telescope may be placed adjacent the laser fiber tip so that the interior wall of the prostatic urethra may be viewed. Irrigating fluid may be provided from a source external of the patient through the endoscopic instrument to a proximity of the tip. Excess fluid may be returned through the instrument to a fluid dump zone external of the patient's body.

Abstract: An angled beam-delivery handpiece includes a barrel for delivering a monochromatic light beam; a contact surface at the distal end of the barrel; a window in the side of the barrel proximate the contact surface; an aperture in the contact surface; and a refractive element in the barrel above the window for diverting the beam carried by the barrel to exit the aperture at an angle to the laser beam in the barrel.