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.

Abstract: A scalpel suitable for Caesarian sections and myometrium sections. The scalpel includes two sides, an edge, a back, and a curved tip. Projections and recesses are alternately formed along the edge. Sharp edges are formed on the projections or the recesses.

Abstract: A laser apparatus and method for permanently removing a plurality of hair follicles from the skin of a patient. The laser apparatus includes a housing having first and second lasers contained therein for emitting at least first and second pulses of coherent light energy; first and second fiber optic bundles connected to the first and second lasers, respectively, for transmitting the pulses of coherent light energy from the first and second lasers; the first and second fiber optic bundles connected to a common fiber optic bundle for combining and transmitting at least first and second pulses of coherent light energy from each of the first and second lasers through the common fiber optic bundle; and a sequence control device for controlling the first and second lasers to emit at least first and second pulses of coherent light energy either sequentially or simultaneously, with a time delay of less than 20 milliseconds between the sequential pulses from the first and second lasers.

Abstract: The disclosure is directed to a tissue ablation device comprising an elongate probe, with a tissue ablation member located at the deflectable distal end of the probe, which is configured to access a patient's heart. The elongate probe is attached at its proximal end to a handpiece which is ergonomically designed to fit within the hand of the operator. The handpiece houses an advancement mechanism which is mechanically coupled to the tissue ablation member and can be used to axially translate the tissue ablation member in relation to the elongate probe. An activation mechanism is housed within the advancement mechanism and is coupled to the advancement mechanism in such a manner that the operator can simultaneously activate and advance the tissue removal member with one finger or thumb. The handpiece also houses a deflection actuator which applies tension to a tensile member which deflects the distal end of the probe.

Abstract: A laser apparatus and method for permanently removing a plurality of hair follicles from the skin of a patient. The laser apparatus includes a housing having a single laser for sequentially emitting a series of pulses of coherent light energy having a pulse width in the range of ½ ms to 40 ms; a fiber optic bundle connected to the laser for transmitting said series of pulses of coherent light energy to the skin of a patient; and a sequence control device for controlling the laser to emit the series of pulses of coherent light energy sequentially, with a time delay of less than 100 milliseconds between the sequential pulses of the single laser. The laser apparatus includes a handpiece assembly for holding a section of the fiber optic bundle for directing the series of pulses of coherent light energy to the same spot of the patient's skin to remove the plurality of hair follicles, veins, or capillaries.

Abstract: A laser apparatus and method for permanently removing a plurality of hair follicles from the skin of a patient. The laser apparatus and method includes a housing having at least first and second lasers contained therein for emitting at least first and second pulses of coherent light energy having a pulse width in the range of 1/2 ms to 40 ms; a first fiber optic bundle connected to the first laser for transmitting at least a first pulse of coherent light energy to the skin of a patient, and a second fiber optic bundle connected to the second laser for transmitting at least a second pulse of coherent light energy to the skin of a patient; and a sequence control device for controlling at least first and second lasers to emit at least first and second pulses of coherent light energy either sequentially or simultaneously, with a time delay of less than 100 milliseconds between the sequential pulses of the first and second lasers.

Abstract: A laser apparatus for permanently removing a plurality of hair follicles or blood vessels from the skin of a patient. The laser apparatus includes a housing having first and second lasers contained therein for emitting at least first and second pulses of coherent light energy; first and second fiber optic bundles connected to the first and second lasers, respectively, for transmitting the pulses of coherent light energy from the first and second lasers; the first and second fiber optic bundles connected to a common fiber optic bundle for combining and transmitting at least first and second pulses of coherent light energy from each of the first and second lasers through the common fiber optic bundle; and a sequence control device for controlling the first and second lasers to emit at least first and second pulses of coherent light energy either sequentially or simultaneously, with a time delay of less than 100 milliseconds between the sequential pulses from the first and second lasers.

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. A handle is described for a flexible optical fiber device which greatly facilitates delivery of the distal end of the optical fiber device to a desired location on the exterior of a patient's heart.

Abstract: A laser treatment apparatus has a hand-piece unit with a laser scanner which deflects a laser beam emitted from a laser source to scan a treatment portion of a patient's skin. In the laser treatment apparatus, the first control device controls the laser scanner to perform a laser scanning irradiation. The detection device detects whether the hand-piece unit is electrically connected with the first control device. When the detection device detects the electrical disconnection of the hand-piece unit to the first control device, the second control device forbids the first control device to conduct the laser scanning irradiation.

Abstract: A laser treatment method and apparatus is provided which facilitates the grafting of hairs on the skin of a living human. The methodology involves a carefully designed treatment protocol utilizing a modified optical apparatus. The apparatus is a modified erbium-based laser system, designed for optimal therapeutic selectivity.

Abstract: A laser treatment method and apparatus is provided which facilitates the grafting of hairs on the skin of a living human. The methodology involves a carefully designed treatment protocol utilizing a modified optical apparatus. The apparatus is a modified erbium-based laser system, designed for optimal therapeutic selectivity.

Abstract: A robotic system that moves a surgical instrument in response to the actuation of a foot pedal that can be operated by the foot of a surgeon. The robotic system has an end effector that is adapted to hold a surgical instrument such as an endoscope. The end effector is coupled to a robotic arm assembly which can move the endoscope relative to the patient. The system includes a computer which controls the movement of the robotic arm in response to input signals received from the foot pedal.

Abstract: A robotic system that moves a surgical instrument in response to the actuation of a control panel that can be operated by the surgeon. The robotic system has an end effector that is adapted to hold a surgical instrument such as an endoscope. The end effector is coupled to a robotic arm assembly which can move the endoscope relative to the patient. The system includes a computer which controls the movement of the robotic arm in response to input signals received from the control panel. The robotic system is mounted to a cart which can be wheeled to and from an operating table. The cart has a clamping mechanism which attaches the cart to the table. The system also contains a spring loaded mount plate that allows the robotic arm to be rotated and adjusted relative to the cart and the patient. Both the robotic arm and the control panel are encapsulated by protective bags that prevent the system from being contaminated.

Abstract: A robotic system that moves a surgical instrument in response to the actuation of a foot pedal that can be operated by the foot of a surgeon. The robotic system has an end effector that is adapted to hold a surgical instrument such as an endoscope. The end effector is coupled to a robotic arm assembly which can move the endoscope relative to the patient. The system includes a computer which controls the movement of the robotic arm in response to input signals received from the foot pedal.

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 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: A robotic system that moves a surgical instrument in response to the actuation of a control panel that can be operated by a surgeon. The robotic system has an end effector that is adapted to hold a surgical instrument such as an endoscope. The end effector is coupled to a robotic arm assembly which can move the endoscope relative to a patient. The system includes a computer which controls the movement of a robotic arm in response to input signals received from the control panel. The robotic system is mounted to a cart which can be wheeled to and from an operating table. The cart has a clamping mechanism which attaches the cart to the table. The system also contains a spring loaded mount plate that allows the robotic arm to be rotated and adjusted relative to the cart and the patient. Both the robotic arm and the control panel are encapsulated by protective bags that prevent the system from being contaminated.

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: A coupler for conveniently coupling an articulated arm to a laser housing whereby the laser beam need not be realigned down the articulated arm each time the arm is coupled to the laser housing. The coupler includes a kinematic plate attached to the laser housing, a sleeve rotationally attached to the plate forming a center bore, and a connector attached to an articulated arm. The connector has a cylindrical shaped projecting member that inserts into the bore of the sleeve. Races are formed on the outer surface of the cylindrical member. The sleeve has roller bearings protruding inside the bore to engage the races. Ball bearings are attached to the end of the cylindrical member to engage the kinematic plate. The races are shaped such that when the sleeve is rotated, the cylindrical member is forced toward the kinematic plate until the ball bearings are secured against the kinematic plate.

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 robotic system that moves a surgical instrument in response to the actuation of a control panel that can be operated by a surgeon. A robotic system has an end effector that is adapted to hold a surgical instrument such as an endoscope. The end effector is coupled to a robotic arm assembly which can move an endoscope relative to a patient. The system includes a computer which controls the movement of a robotic arm in response to input signals received from the control panel. The robotic system is mounted to a cart which can be wheeled to and from an operating table. The cart has a clamping mechanism which attaches the cart to the table. The system also contains a spring loaded mount plate that allows the robotic arm to be rotated and adjusted relative to the cart and the patient. Both the robotic arm and the control panel are encapsulated by protective bags that prevent the system from being contaminated.

Abstract: A robotic system that moves a surgical instrument in response to the actuation of a foot pedal that can be operated by the foot of a surgeon. The robotic system has an end effector that is adapted to hold a surgical instrument such as an endoscope. The end effector is coupled to a robotic arm assembly which can move the endoscope relative to the patient. The system includes a computer which controls the movement of the robotic arm in response to input signals received from the foot pedal.

Abstract: A robotic system that moves a surgical instrument in response to the actuation of a foot pedal that can be operated by the foot of a surgeon. The robotic system has an end effector that is adapted to hold a surgical instrument such as an endoscope. The end effector is coupled to a robotic arm assembly which can move the endoscope relative to the patient. The system includes a computer which controls the movement of the robotic arm in response to input signals received from the foot pedal.

Abstract: A balloon for an inter aortic balloon pump having an elongate tapered section extending from a proximal end of minimal diameter and progressively increasing in diameter toward the distal end. The tapered section is of greater wall thickness with the wall thickness becoming progressively thinner toward the distal end.

Abstract: A dental laser treatment unit, especially for medical or dental purposes having a control unit and a supply device, connected with the control unit by a releasable connection, for a laser treatment instrument.

Abstract: A slit incision handpiece that receives a circular laser beam, reshapes the beam to have an elliptical cross-section, and focuses the beam onto target tissue. Slit incisions of approximately the dimensions of the elliptical beam are formed by stationary exposures on the target tissue from the output of the slit incision handpiece.

Abstract: A laser delivery system which may be coupled to a stereomicroscope or camera equivalent, may be three dimensionally positioned such that a laser beam may irradiate a wide range of treatment sites from a variety of angles and distances, and where the laser beam may be positioned at an angle to the viewing axis and track along therewith. A laser delivery system including a filter/mirror system which allows only proper wavelengths to be transmitted.

Abstract: A slit incision handpiece that receives a circular laser beam, reshapes the beam to have an elliptical cross-section, and focuses the beam onto target tissue. Slit incisions of approximately the dimensions of the elliptical beam are formed by stationary exposures on the target tissue from the output of the slit incision handpiece.

Abstract: A medical laser delivery system usable to transmit laser energy from a laser energy source to a surgical site of a patient. The delivery system includes a handpiece adapted for rotatable coupling to a delivery arm coupled to the laser energy source such that the handpiece is rotatable about its longitudinal axis with respect to the delivery arm. A distal delivery system is coupled to the handpiece and delivers laser energy to the surgical site when the laser energy source is actuated. The handpiece includes a handpiece body adapted for rotatable coupling to the delivery arm and a handpiece head coupled to both the handpiece body and the distal delivery system. The handpiece head can be rotatably coupled to the handpiece body. In one embodiment, the handpiece head is angularly oriented at a fixed angle with respect to the handpiece body.

Abstract: A technique is disclosed for wound debridement in which a pulsed CO.sub.2 laser beam is caused to impinge upon exposed tissue with individual pulses sufficiently energetic to ablate a thin layer of tissue. Each pulse has a time duration short enough to cause ablation but long enough so that it does not cause atmospheric breakdown. The CO.sub.2 laser, with a wavelength in the far infrared region, is operated to produce a pulsed beam with individual pulses having an energy of about one joule per pulse or greater. The beam is focused to produce a beam diameter with a fluence of approximately ten joules per square centimeter at the tissue to be ablated and with a pulse repetition rate of approximately one hundred pulses per second and a pulse duration between one microsecond and ten microseconds. In operation, the ablation of eschar is achieved over a relatively wide range of angles of incidence without need for change of the beam parameters.

Abstract: A decoupled dual-beam control system for a compact micromanipulator unit for a surgical laser system includes a focusing mechanism for focusing a first laser beam of a first wavelength at a predetermined focal point; and a control mechanism for directing a second laser beam of a second wavelength onto the focusing mechanism; the control mechanism includes a device for varying the diameter and wavefront of the second laser beam at the focusing mechanism for enabling the focusing mechanism to focus the second beam in the same focal plane as the first beam. The control mechanism further includes a device for translating the second beam relative to the focusing mechanism for enabling the focusing mechanism to coincidentally position the foci of the surgical and aiming beams in the focal plane.

Abstract: A technique is disclosed for wound debridement in which a pulsed CO.sub.2 laser beam is caused to impinge upon exposed tissue with individual pulses sufficiently energetic to ablate a thin layer of tissue. Each pulse has a time duration short enough to avoid deleterious heat penetration but long enough so that it does not cause atmospheric breakdown. The CO.sub.2 laser, with a wavelength in the far infrared region, is operated to produce a pulsed beam with individual pulses having an energy of about one joule per pulse or greater. The beam is focused to produce a beam diameter with a fluence of approximately ten joules per square centimeter at the tissue to be ablated and with a pulse repetition rate of approximately one hundred pulses per second and a pulse duration between one microsecond and ten microseconds.

Abstract: An apparatus for performing controlled tissue ablation in endolaser microsurgery is disclosed, the apparatus including a laser delivery system coupled to a probe capable of transmitting the laser power through a suitable medium such as sapphire. The probe may include a central canal for aspiration and irrigation and delivers a cross-sectionally homogeneous power distribution. The apparatus is designed to control the ablation depth and to limit the zone of thermal damage in the remaining tissue.

Abstract: A laser therapeutic apparatus for treating a patient by irradiating selected body parts by laser beams generated by a plurality of laser probes. The laser probes are supported by a common support table and a lock mechanism is provided to selectively lock and release the laser probes to maintain and release the orientation thereof. Each laser probe includes an inner cylinder and an outer cylinder and a spring for biasing the inner cylinder axially within the outer cylinder. The end of the inner cylinder is provided with one or more lights that are energized when the associated probe is emitting a laser beam. The end of each laser probe further includes indicating rings for visually indicating the extent of the axial movement of the inner cylinder with respect to the outer cylinder.

Abstract: A coupler 30 for use with medical laser delivery systems is disclosed. The delivery system includes an articulated arm and an endoscope 42. The coupler 30 connects the arm to the endoscope. The coupler includes an axially extending tube 46 receivable in the bore 48 of the endoscope. The tube facilitates alignment of the coupler with the endoscope. The coupler is also provided with a telescope optical system (50, 52) for adjusting the diameter of the beam at the entrance to the endoscope to reduce clipping of the beam thereby enhancing transmission.

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.

Abstract: A heart-synchronized vacuum-assisted pulsed laser technique generates a valve control signal in response to the ECG of a beating heart which is to be synchronized with the laser; the valve control signal is applied to a valve to open it and permit laser gas to be delivered to the gas inlet of the laser assisted by the draw from a vacuum source at the gas outlet of the laser, to produce a predetermined range of laser gas pressure in the laser; the valve control signal is ceased after the predetermined range of laser gas pressure has been reached to end the gas flow through the laser and enable the rebuilding of the vacuum in the vacuum source; and a laser firing signal is generated to fire the laser when the laser gas pressure is in the predetermined range.

Abstract: Apparatus and method for laser surgery in which laser energy, pulsed or continuous, is focussed to a focus spot of ten to thirty microns which is located within tissue, or the like to cause highly localized heating. The pulsed radiation is in the TEM(oo) mode, has a wavelength of approximately 1064 nanometer, the pulses being not in excess of 100 nanoseconds and the pulse rate being approximately 2000 per second. Where the laser beam is continuous or pulsed, it has a wavelength of approximately 1400 to 1800 nanometer, or in photoablative modes, having a wavelength of 190 to about 300 nanometers. The focus spot may be caused to move relative to the axis of a handpiece; and to liquid may flow across the exposure site to remove debris.

Abstract: The surgical equipment comprises a sealed CO.sup.2 working laser (13) and a sighting He Ne-laser (12) the beams of which are superimposed; a cooling circuit of the working laser comprising a heat exchanger the secondary of which is fed with a liquid circulated by a pump (24), the same pump feeding through the intermediary of a three-way valve (25), either the said secondary circuit of the heat exchanger, or a duct feeding a nozzle emitting a water jet. The beams of the lasers and the duct feeding the nozzle are housed in a supple or articulated arm (10) connected to the hand piece (11) into which is further inserted thermographic visualization equipment of the operating field.

Abstract: A medical treatment laser is disclosed that minimizes absorption of laser energy along the beam path by using a lasing medium having a principal emission at a wavelength shifted from the absorption wavelength. In the preferred embodiment, a CO.sub.2 laser filled with the .sup.13 C.sup.16 O.sub.2 isotope is used. The .sup.13 C.sup.16 O.sub.2 isotope generates a laser beam having a principal emission wavelength near 11.2 microns. The absorption of this wavelength in the conventional CO.sub.2 purge and insufflation gases is quite small compared to the absorption of the 10.59 micron wavelength emitted by the standard CO.sub.2 isotope. The difference in absorption allows the power generated by the laser to be maximally transmitted to the medical treatment site. In addition, the 11.2 micron line has a greater coefficient of absorption in human tissue, thereby enhancing surgery.

Abstract: An instrument for the surgical removal of a conical piece of tissue having an aperture from a human or other animal body using a laser beam has a laser beam guide housing which is made up of a tube, through which the inlet laser beam passes, of an inlet deflecting member for deflecting the laser beam from its inlet direction and of an outlet deflecting member, arranged at a lateral distance from the latter, to deflect the beam along an outlet direction thereof so that on twisting the guide housing about the inlet direction the emerging laser beam sweeps out a conical surface. The outlet deflecting member is arranged on a boom member extending laterally from the tube. The instrument furthermore has a guide pin which centers the guide housing by being inserted in the tissue aperture. The guide pin and the guide housing are able to be rotated in relation to each other.

Abstract: A delivery arrangement for CO.sub.2 (carbon dioxide) laser radiation is described which is particularly designed for laser medical systems. The delivery arrangement has three components--an articulated arm connectable to a CO.sub.2 laser head, a waveguide probe for directing CO.sub.2 laser radiation to an operating site, and a coupler for conditioning CO.sub.2 laser radiation emanating from the arm for coupling into the waveguide probe.