A tapered fiber optoacoustic emitter includes a nanosecond laser configured to emit laser pulses and an optic fiber. The optic fiber includes a tip configured to guide the laser pulses. The tip has a coating including a diffusion layer and a thermal expansion layer, wherein the diffusion layer includes epoxy and zinc oxide nanoparticles configured to diffuse the light while restricting localized heating. The thermal expansion layer includes carbon nanotubes (CNTs) and Polydimethylsiloxane (PDMS) configured to convert the laser pulses to generate ultrasound. The frequency of the ultrasound is tuned with a thickness of the diffusion layer and a CNT concentration of the expansion layer.

Systems, devices, and methods for delivering laser energy to a target in an endoscopic procedure are disclosed. An exemplary method comprises providing a first laser pulse train and a different second laser pulse train emitting from a distal end of an endoscope and incident on a target. The first laser pulse train has a first laser energy level, and the second laser pulse train has a second laser energy level higher than the first laser energy level. In an example, the first laser pulse train is used to form cracks on a surface of a calculi structure, and the second laser pulse train causes fragmentation of the calculi structure after the cracks are formed.

A method of optimizing the irradiation of a target with laser radiation includes selecting and mounting on a laser radiation delivery device either a waveguide or optical fiber type to be used; also, selecting at least the following parameters: selecting the total energy of the at least one train of pulses to be delivered to the target, and selecting the distance from the distal delivery end to the target; then, initiating irradiation of the target for the at least one train of pulses by generating a first laser pulse with sufficient energy (E.sup.i) to form a vapor bubble in a liquid medium; allowing the vapor bubble formed to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the distal delivery end and the target; and, thereafter, after the selected time delay (T.sup.d) sufficient for the formed vapor bubble to reach its optimum extent, generating a second laser pulse (E.sup.p), the second laser pulse being delivered to the target through the formed vapor bubble.

Treatment systems are provided, which comprise a treatment element applying a treatment to a tissue, a stimulation element optically stimulating nerves in the tissue, a sensing unit sensing an electrical signal produced by nerves in the tissue in response to the optical stimulation, and a control unit controlling the application of the treatment according to the sensed signal. The systems and methods are used to avoid damaging nerves by sensing them during operation and immediately before local treatment application and preventing energy emission when the treatment tool is too close to specified nerves. Additional electric stimulation may be provided to enable avoidance of nerve damages on a larger scale, the treatment may be applied by a cold laser, and the control unit may control the treatment in realtime and in a closed loop and immediate prevent further treatment upon sensing optically stimulated nerves.

Treatment systems are provided, which comprise a treatment element applying a treatment to a tissue, a stimulation element optically stimulating nerves in the tissue, a sensing unit sensing an electrical signal produced by nerves in the tissue in response to the optical stimulation, and a control unit controlling the application of the treatment according to the sensed signal. The systems and methods are used to avoid damaging nerves by sensing them during operation and immediately before local treatment application and preventing energy emission when the treatment tool is too close to specified nerves. Additional electric stimulation may be provided to enable avoidance of nerve damages on a larger scale, the treatment may be applied by a cold laser, and the control unit may control the treatment in realtime and in a closed loop and immediate prevent further treatment upon sensing optically stimulated nerves.

A surgical system configured for treating tissue is provided. The surgical system includes a laser source and a laser scalpel. The laser scalpel is adapted to couple to the laser source and is operable in two modes of operation, a first mode of operation to analyze tissue of interest and a second mode of operation to treat tissue of interest. The laser scalpel includes a housing having first and second fiber optic cables extending therethrough. Each of the first and second fiber optic cables operable under the first mode of operation to collect information pertaining to at least one optical property of tissue of interest and at least one of the first and second fiber optic cables also operable under the second mode of operation to treat the tissue of interest.

A surgical system configured for treating tissue is provided. The surgical system includes a laser source and a laser scalpel. The laser scalpel is adapted to couple to the laser source and is operable in two modes of operation, a first mode of operation to analyze tissue of interest and a second mode of operation to treat tissue of interest. The laser scalpel includes a housing having first and second fiber optic cables extending therethrough. Each of the first and second fiber optic cables operable under the first mode of operation to collect information pertaining to at least one optical property of tissue of interest and at least one of the first and second fiber optic cables also operable under the second mode of operation to treat the tissue of interest.

Certain embodiments disclosed herein provide systems and devices for coupling optical fibers with laser surgical systems. In particular, certain aspects provide a push-pull connector and adapter for releasably coupling an optical fiber with a port of a laser surgical system. The connector and adapter facilitate mechanical lateral and rotational guidance of the optical fiber during insertion into the port to ensure proper alignment (e.g., clocking) of the optical fiber’s cores with a laser beam pattern propagated by the laser surgical system. Accordingly, the connector and adaptor enable improved coupling efficiency between the laser beam pattern and one or more cores of the optical fiber, and therefore improved power uniformity between multiple laser beams transmitted through the cores.

Certain embodiments disclosed herein provide systems and devices for coupling optical fibers with laser surgical systems. In particular, certain aspects provide a push-pull connector and adapter for releasably coupling an optical fiber with a port of a laser surgical system. The connector and adapter facilitate mechanical lateral and rotational guidance of the optical fiber during insertion into the port to ensure proper alignment (e.g., clocking) of the optical fiber’s cores with a laser beam pattern propagated by the laser surgical system. Accordingly, the connector and adaptor enable improved coupling efficiency between the laser beam pattern and one or more cores of the optical fiber, and therefore improved power uniformity between multiple laser beams transmitted through the cores.

A variable length interstitial probe apparatus includes: a probe for effecting thermal therapy and/or cryotherapy to a tissue; a flexible umbilical sheath permanently affixed to the probe, including at least one interface for supplying energy, cooling fluid, cooling gas, heating fluid, and/or heating gas to the probe; and an adjustable depth stop configured to slide along a length of a shaft region of the probe, and lock to the shaft region at a selected position. The adjustable depth stop is configured to engage a probe driver and/or a skull mount apparatus to stabilize positioning of the probe and to control a depth of entry of the probe into a patient. The probe may be configured to effect temperature modulation therapy, where processing circuitry activates a modulation pattern of thermal therapy emission and cryogenic therapy emission for applying a thermal dose to the tissue.