An apparatus (20) for performing endoscopic surgery on a patient (12) includes at least two concentric tube manipulators (150) adapted to carry devices (152, 154) for performing a surgical operation. A transmission (200) operates the concentric tube manipulators (150). An endoscope tube (106) has a proximal end portion fixed to the transmission (200). The concentric tube manipulators (150) extend from the transmission (200) through an inner lumen (102) of the endoscope tube (106) and are operable to extend from a distal end (104) of the endoscope tube.

A steerable laser probe may include a handle having a handle distal end and a handle proximal end, an actuation lever 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 the actuation lever may gradually curve the flexible housing tube and the optic fiber. An actuation of the actuation lever may gradually straighten the flexible housing tube and the optic fiber.

Described herein are methods, devices, and support structures for assembling optical fibers in catheter tips and facilitating alignment and structural support. A method for assembling a plurality of optical fibers and lenses in a support structure for an ablation catheter includes providing a support structure with a proximal end, a body, and a distal end, the distal end including a plurality of alignment orifices or slits. A plurality of optical fibers are threaded through the alignment orifices or slits, such that each optical fiber is threaded through a corresponding alignment orifice or slit. An adhesive material is applied at each alignment orifice or slit to secure the optical fibers, and the plurality of optical fibers are then cleaved at the distal end to remove portions of the fibers extending out of the distal end. Finally, a lens is attached to each of the ends of the plurality of optical fibers.

Medical treatment devices for treating a tissue are disclosed. The medical treatment devices may comprise an optical fiber with a treatment section as well as an illumination source configured to deliver electromagnetic radiation through the optical fiber to apply a specified treatment. The treatment section may comprise at least one element with a refractive index that may be different from a refractive index of the optical fiber and/or may be same as the refractive index of the optical fiber. A spatial configuration of the optical and the at least one element within the treatment section of the medical treatment device and/or optical properties of the optical fiber and/or the at least one element may determine an emission region through the treatment section. The emission region may be radial (or at least have a radial component) with respect to a cross-section of the optical 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.

A steerable laser probe may include a handle, an actuation structure of the handle, a housing tube, a wire having a pre-formed curve, and an optic fiber disposed within the housing tube and an inner bore of the handle. The housing tube may include a first housing tube portion having a first stiffness and a second housing tube portion having a second stiffness. The second stiffness may be greater than the first stiffness. A compression of the actuation structure may curve or straighten the housing tube. A decompression of the actuation structure may curve or straighten the housing tube.

An apparatus (20) for performing endoscopic surgery on a patient (12) includes at least two concentric tube manipulators (150) adapted to carry devices (152, 154) for performing a surgical operation. A transmission (200) operates the concentric tube manipulators (150). An endoscope tube (106) has a proximal end portion fixed to the transmission (200). The concentric tube manipulators (150) extend from the transmission (200) through an inner lumen (102) of the endoscope tube (106) and are operable to extend from a distal end (104) of the endoscope tube.

An energy-based surgical system includes a light beam source and a probe. The light beam source is configured to selectively provide a beam of light. The probe defines a channel about a longitudinal axis thereof and a side opening near a distal end thereof. The channel is operatively connected to the light beam source and is configured to transmit the beam of light from the side opening. The beam of light is configured to detect the presence of a nerve within targeted tissue. The probe may further be configured apply treatment energy to tissue to treat tissue.

A surgical laser system comprises a laser source configured to generate laser energy; a laser fiber optically coupled to the laser source and configured to discharge the laser energy generated by the laser source; a rocker arm configured to control an orientation of the discharged laser energy; and a controller configured to control a movement of the rocker arm in response to feedback of the discharged laser energy or to pre-defined settings of the laser source.

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.