A device and method for treating a vagina's anatomic, functional and aesthetic conditions are disclosed. Device comprises a laser energy source which conveys laser energy through an optical fiber handpiece. A cylindrical/penis shaped device/applicator is specially designed for safe and accurate irradiation of determined parts of vaginal mucosa. Applicator has an inner hollow path through which optical fiber is inserted to irradiate interior vaginal tissue. Irradiated mucous tissue contracts, reducing vaginal radius and during penetration in sexual intercourse it embraces penis more tightly. Sensitivity is substantially improved and sexual intercourse is more pleasurable for both partners. In one embodiment, a 1470 nm diode laser source is used. In another embodiment, a vagina's outer dimensions are accurately measured and surgery is performed to achieve dimensions according to certain aesthetic and functional criteria. Minimum pain and risk of side effects are experienced with this ambulatory procedure performable in a physician's office.

A steerable endoscopic tool uses concentric sleeves of varying curvature to steer a tool tip toward or in the direction of a location of surgical interest. By rotating and/or axially displacing such sleeves relative to one another the tool tip may be maneuvered within a current field of view with several degrees of freedom without any physical movement of an endoscope, thus facilitating improved surgical access and control without complex mechanical systems in the endoscope or at the surgical site.

Ablation and visualization systems and methods to access quality of contact between a catheter and tissue are provided. In some embodiments, a method for monitoring tissue ablation of the present disclosure comprises advancing a distal tip of an ablation catheter to a tissue in need of ablation; illuminating the tissue with UV light to excite NADH in the tissue, wherein the tissue is illuminated in a radial direction, an axial direction, or both; determining from a level of NADH fluorescence in the illuminated tissue when the distal tip of the catheter is in contact with the tissue; and delivering ablation energy to the tissue to form a lesion in the tissue.

A surgical laser system includes a laser source configured to generate laser energy, a laser fiber optically coupled to the laser source and configured to discharge the laser energy and collect electromagnetic energy feedback from a treatment site a photodetector configured to generate an output signal in response to the electromagnetic energy collected from the treatment site, a display, and a controller configured to produce an image or indication about the temperature at the treatment site on the display based on the output signal.

Exemplary methods and devices can be provided for improving the appearance of dermal melasma. This can be done, e.g., focusing electromagnetic radiation having a wavelength between about 600 nm and 850 nm into a region of the pigmented dermal tissue at a depth between about 150 and 400 microns, using a lens arrangement having a large numerical aperture between about 0.5 and 0.9. The exemplary local dwell time of the focused radiation can be less than a few milliseconds, and a local fluence provided in the focal region can be between about 50 and 500 J/cm.sup.2. The focal region can be scanned through the dermal tissue at speeds on the order of a few cm/s. Such parameters can provide sufficient energy absorption by pigmented cells in the dermis to disrupt them while avoiding damage to the overlying tissue and unpigmented dermal tissue.

In one embodiment, a handheld laser treatment apparatus comprises: a handset including a treatment chamber, the treatment chamber having an open treatment aperture; a laser array arranged to project optical energy into the treatment chamber and coupled to a power source; at least one vacuum channel positioned within the treatment chamber and coupled to a vacuum source; a trigger sensor coupled to logic that controls activation of the laser array and the vacuum channel; an attachment sensor arranged to detect which of a plurality of attachments are inserted into the treatment chamber through the treatment aperture. The logic enables activation of the vacuum channel when the attachment sensor detects a first attachment of the plurality of attachments inserted into the treatment aperture. The logic disables activation of the vacuum channel when the attachment sensor detects a second attachment of the plurality of attachments inserted into the treatment aperture.

The invention provides a non-invasive skin treatment device (200) comprising: a light source (10) constructed for emitting treatment light (15), an optical system (20) constructed for focusing the treatment light along an optical axis (OA) to a focus position (320) inside the skin tissue (300), and an indenter (30) comprising a skin contact surface (34) having an aperture (A1) at a distance from the optical system for allowing the treatment light to be focused through the aperture into the skin tissue. The indenter is configured and constructed for generating, in a cross-section of the aperture taken along the optical axis and along a cross-section direction wherein the aperture has a width dimension, a maximally curved protrusion of skin tissue freely protruding through the aperture towards the optical system by pressing the indenter against the skin surface of a specific skin type with a pressure exceeding a predefined pressure, a skin surface of said maximally curved protrusion having a radius of curvature (RC) at an intersection with the optical axis. The optical system is configured and constructed for generating a focused beam of the treatment light having, in said cross-section of the aperture at said intersection, a wave front with a radius of curvature ranging between 75% and 125% of said radius of curvature (RC) of the skin surface of said maximally curved protrusion.

Embodiments of a surgical laser systems may include a laser source configured to generate a laser energy; a laser fiber optically coupled to the laser source to discharge laser energy; a photodetector configured to generate an output signal indicative of an intensity level of electromagnetic energy feedback produced in response to the discharge of the laser energy; and a controller configured to control the laser source based on the output signal. Embodiments of a method of controlling a surgical laser system also are disclosed, wherein laser energy is generated using a laser source and discharged through a laser fiber. Electromagnetic energy feedback produced in response to discharging the laser energy is delivered to a photodetector. An output signal from the photodetector is analyzed using a controller. The laser source is controlled in response to analyzing an output signal using the controller.

A system and method for treating ophthalmic target tissue, including a light source for generating a beam of light, a beam delivery system that includes a scanner for generating patterns, and a controller for controlling the light source and delivery system to create a dosimetry pattern of the light beam on the ophthalmic target tissue. One or more dosage parameters of the light beam vary within the dosimetry pattern, to create varying exposures on the target tissue. A visualization device observes lesions formed on the ophthalmic target tissue by the dosimetry pattern. The controller selects dosage parameters for the treatment beam based upon the lesions resulting from the dosimetry pattern, either automatically or in response to user input, so that a desired clinical effect is achieved by selecting the character of the lesions as determined by the dosimetry pattern lesions.

In some embodiments, the inventive subject matter is directed to a multimode electrosurgical system having an electrosurgical instrument with a first electrode configuration that operates in a bipolar mode and second electrode configuration that operates in a monopolar mode. In other embodiments, the inventive subject matter is directed to an instrument and system that provide multiple modes of surgical and/or therapeutic treatments, at least one being an electrosurgical mode of treatment, the instrument including at least one active electrode on a working portion, and the working portion including or supporting at least one non-electrosurgical functional element, the instrument including at least one operational return electrode configuration of selectively variable surface area.