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.

A hand piece for handling an optical fiber during a laser-surgical intervention comprises a handle body elongated along a main axis and having a through hole extending along the main axis. A guide tube having a tube lumen aligned and communicating with the through hole is attached to the handle body. A fixing device is provided in the handle body for fixing the optical fiber extending through the through hole and the tube lumen in direction of the main axis. The guide tube is made of a shaped memory alloy, which has a transition temperature between 50 C. and 120 C., and which has a straight base shape. Below the transition temperature, the guide tube is bendable by plastic deformation out of the straight base shape into a curved shape, and, when heated up above the transition temperature, the guide tube returns to its straight base shape.

An example probe multi-spot, multi-fiber, laser probe includes a plurality of optical fibers extending from a proximal end of the laser probe to at least near a distal end of the laser probe, and a cannula having a distal end and surrounding the plurality of optical fibers along at least a portion of the laser probe at or near the distal end of the laser probe. A distal pass-through element is positioned within the cannula and at or near the distal end of the cannula and has a groove and/or channel corresponding to each fiber and through which a respective optical fiber passes, and is formed so as to induce a radial rotation of each of the plurality of optical fibers, relative to a central longitudinal axis of the cannula, as the respective optical fiber passes through the distal pass-through element.

The device serves for the controlled conveying of a cable. The device has a housing, having a cover plate, on which are externally mounted a drive wheel and contact wheel which can be radially pressed onto the drive wheel, between which the cable can be clamped. The cable can be conveyed by means of the drive wheel being driven by a drive unit in the interior of the housing. The rotational motion of the drive wheel is guided through a stationary light barrier by means of a counting disc, running synchronously therewith and having radial slots or holes in the circumferential area, for determining the motion and rotational speed of the drive wheel. The cover plate and the housing can be sterilized. The drive unit in the interior of the housing is not sterilizable, yet is completely enclosed by the sterilized housing and cover plate.

A microsurgical probe employs an optional probe support structure; an optical fiber for providing a feed path for an emission wavelength; a chemical feed path for delivering a chemical; a resonator motor; and a probe accessory tool. A microsurgical system additionally employs a sensor and an artificial intelligence (AI) system to assess conditions based on data provided by the sensor. The system can be employed to remove tumor tissue that is interwoven with healthy tissue. This system can also be employed to fertilize old, inflexible ova.

A steerable laser probe may include a handle having a handle distal end and a handle proximal end, a flexible housing tube having a flexible housing tube distal end and a flexible housing tube proximal end, an actuation mechanism control of the handle, and an optic fiber disposed within an inner bore of the handle and within the flexible housing tube. An actuation of the actuation mechanism control may be configured to gradually curve the flexible housing tube. A gradual curving of the flexible housing tube may be configured to gradually curve the optic fiber. An actuation of the actuation mechanism control may be configured to gradually straighten the flexible housing tube. A gradual straightening of the flexible housing tube may be configured to gradually straighten the optic fiber.

Small diameter tools are provided, and methods of use described, to facilitate less invasive surgical procedures employing laser beams. Such tools include distal tips that enhance the precise placement of optical waveguides, as well as enable cutting and dissecting procedures. A rotary coupler allows precise control of flexible conduits in which waveguides may be disposed. Waveguide tips with conical features protect waveguide ends and allow unobstructed propagation of the laser beam out of the waveguide. A preferentially bending jacket for waveguides may be used to control an orientation of a waveguide disposed therein. Surgical waveguide assemblies may include various combinations of these components.

A device includes a catheter section comprising a flexible joint region disposed between a distal end and a proximal end. The device includes a laser fiber disposed within the catheter section. The laser fiber emits laser light at a fiber distal end. The device includes a wire comprising a distal end coupled to the catheter section. The wire is configured to move the distal end of the catheter section from a first position to a second position about the flexible joint region.

A steerable laser probe may include a handle having a handle distal end and a handle proximal end, a plurality of actuation controls of the handle, a flexible housing tube having a flexible housing tube distal end and a flexible housing tube proximal end, and an optic fiber disposed within an inner bore of the handle and the flexible housing tube. An actuation of an actuation control of the plurality of actuation controls may gradually curve the flexible housing tube. A gradual curving of the flexible housing tube may gradually curve the optic fiber. An actuation of an actuation control of the plurality of actuation controls may gradually straighten the flexible housing tube. A gradual straightening of the flexible housing tube may gradually straighten the optic fiber.

Devices and methods are discussed directed to the use of a low profile laser ablation catheter for use in laser ablation removal of arterial plaque blockages to restore blood flow in the treatment of arteriovenous fistulas. Also discussed are devices and methods directed to packaging, long term storage and sterilization of liquid core ablation catheters.