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/cm.sup.2, in a spot size of at least 0.05 mm.sup.2.

A surgical cutting tool guide (20, 320, 420, 520) includes a target arm (30) and primary and secondary sight arms (32A, 32B), which are pivotably attached to the target arm (30) so as to be rotatable with respect to one another about primary and secondary target pivot points (34A, 34B), respectively. A sight (40) includes a sight housing (42), which defines a sight passage (44) for aligning a surgical cutting tool (22) with a sight target axis (46), and is attached to the primary and the secondary sight arms (32A, 32B) such that the sight housing (42) and the primary and the secondary sight arms (32A, 32B), respectively, are rotatable with respect to each other about the primary and secondary sight pivot points (34A, 34B), respectively. The surgical cutting tool guide (20, 320, 420, 520) is arranged to automatically and non-electrically maintain the sight target axis (46) oriented to pass within an offset distance of a target point (60) over an entire range of angles over which the sight (40) directs the sight passage (44) toward the target point (60).

A cooling element includes a frame including one or more datums. The cooling element also includes a first window including a first proximal surface and a first distal surface. The first window is sealed to the frame. The cooling element further includes a second window sealed to the frame. The second window includes a second proximal surface and a second distal surface. The second window is configured to contact a target tissue or a tissue adjacent to the target tissue via the second distal surface. The cooing element also includes a coolant chamber located between the first distal surface of the first window and the second proximal surface of the second window and configured to receive a coolant. The first window, the second window and the coolant chamber are configured to receive and electromagnetic radiation (EMR), and transmit a portion of the received EMR to the target tissue.

An arrangement that prevents carbonization of cladding, coating, or buffer layers of a surgical laser fiber due to thermal radiation reflected back into the fiber from, or emitted by, a target of the laser, includes a thermal radiation blocking, absorbing or diverting structure. The thermal radiation blocking, absorbing or diverting structure surrounds an end portion of the fiber that has been stripped of one or more coating and/or buffer layers, and may be made of a heat resistant material such as PTFE or polyimide to block heat from reaching the coating or buffer layers, an optical ferrule such as fused silica to guide the heat away from the fiber coating or buffer layers, or a high refraction index material such as UV adhesive. The end of the fiber, including the thermal radiation blocking, absorbing or diverting structure and, optionally, at least a portion of the coating or buffer layer, may be standoff or protective sleeve structure such as a soft polymer tip or a metal, fused silica, quartz or ceramic ferrule. The standoff or protective sleeve structure may be flush with a tip of the fiber to limit erosion due to contact with the surgical laser target, or extend beyond the fiber to tip to eliminate erosion by preventing initial contact.

A cosmetic method of directionally tightening human skin tissue includes providing an ablative laser source and a non-ablative laser source, then using the ablative laser source to form one or more overlapping circular shaped microchannels in the skin tissue; the overlapping microchannels formed have a longitudinal dimension larger than their cross dimension; then, using the non-ablative laser source to weld the microchannels, whereby the welding causes the skin tissue to tighten.

The present disclosure enables improved laser treatments by enabling better estimation of laser-tissue interaction to better inform the planning of a treatment path for a laser signal through a treatment region. An embodiment in accordance with the present disclosure uses a laser signal to generate a feature in the treatment region, generates a surface profile of the treatment region that includes the feature, compares that surface profile to another surface profile of the treatment region taken before the generation of the feature, and infers at least one property for at least one tissue type in the treatment region based on the comparison. In some embodiments, the feature is generated such that it includes a plurality of tissue types previously identified in the treatment region, thereby enabling inference one or more properties for each tissue type and/or locating one or more boundaries between tissue types.

A method for treating a treatment site within or adjacent to a vessel wall or a heart valve, includes the steps of (i) generating light energy with a light source; (ii) positioning a balloon substantially adjacent to the treatment site, the balloon having a balloon wall that defines a balloon interior that receives a balloon fluid; (iii) receiving the light energy from the light source with a light guide at a guide proximal end; (iv) guiding the light energy with the light guide in a first direction from the guide proximal end toward a guide distal end that is positioned within the balloon interior; and (v) optically analyzing with an optical analyzer assembly light energy from the light guide, wherein the light energy that is analyzed moves in a second direction that is opposite the first direction.

A catheter assembly is provided having a working lumen and a guide. The guide is configured to position a fragmentizing device within the working lumen. The guide is configured to prevent or minimize any unintended movement of a distal section of the fragmentizing device within the working lumen when the distal section of the fragmentizing device is positioned at a distal end of the working lumen.

A laser tissue ablation system can include an optical fiber, with a distal end being extendible from an endoscope body of an endoscope. The optical fiber can deliver therapeutic laser light from the distal end of the optical fiber toward a target site, and receive return light into the distal end of the optical fiber. The laser tissue ablation system can include a sensor that can spectrally measure the return light. The laser tissue ablation system can include processor circuitry that can form a first determination, from the spectral measurement of the return light, whether flashing event light is present in the return light. The flashing event light can be generated when a flashing event occurs at the distal end of the optical fiber. The processor circuitry can generate, in response to the first determination, a flashing event data signal that indicates whether the flashing event has occurred.

An ophthalmological laser device for treatment of eye tissue is disclosed, comprising a base station having a treatment laser source configured to generate a treatment laser beam, an application head, an arm arranged between the base station and the application head, wherein the arm is configured to provide a beam path for the treatment laser beam, the arm having at least one joint, and a scanner arranged in the joint and configured to dynamically deflect the treatment laser beam about two axes, wherein the treatment laser beam upstream of the scanner is collinear with an axis of rotation of the joint and an orientation of the scanner is dependent on a movement of the joint.