A tool has a handle and an elongate shaft that extends distally from the handle. A distal portion of the shaft is inserted into a subject during a surgical procedure. An optical fiber delivers laser energy to a tip at the distal portion of the shaft. The tip includes a mechanical cutting mechanism including a moving part that absorbs the laser energy, thermally conducts the absorbed energy to tissue that is disposed between the moving part and another part, and moves with respect to the other part in order to cut tissue that is disposed between the parts using a mechanical force that is lower than a mechanical force that would be required to cut the tissue in the absence of the laser energy. Other embodiments are also described.

The present disclosure relates to a fiber and a laser probe assembly with a probe tip that houses the fiber. In certain aspects, the fiber includes a core, an outer cladding surrounding the core, and an end face at a proximal and/or distal end of the fiber. The core is configured to transmit a laser light beam while the core and the outer cladding are both configured to transmit an illumination light. In certain aspects, a surface area of the end face corresponding to a cross-section of at least the outer cladding is treated with a roughening or polishing process to modulate an illumination light output angle of the fiber. Using a fiber that is configured to transmit a laser light beam as well as a wide-angle illumination light allows for a more compact fiber and probe tip, allowing for medical procedures that require a narrower probe.

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.

A steerable laser probe may include a handle having a handle distal end and a handle proximal end, an auto-fixing actuation control, a housing tube having a housing tube distal end and a housing tube proximal end, a first housing tube portion having a first stiffness, a second housing tube portion having a second stiffness, and an optic fiber disposed within an inner bore of the handle and the housing tube. An actuation of the auto-fixing actuation control may gradually curve the housing tube. A gradual curving of the housing tube may gradually curve the optic fiber.

A fiber optic medical device/system is presented, comprising means to connect and enclose a laser source to ensure sterility and safe operation. Device includes a low cost, single use system enclosed and sterilized including laser source and with the fiber attached in a sterile tube. Another embodiment comprises hermetically sealed laser unit with simple connection system to a properly shaped fiber optic, after joining, unit comprises a hand piece and fiber for direct insertion to treat target tissue. Laser handle is aseptically packaged. In other embodiments, fiber is proximally terminated in solid funnel-shaped end to provide unique directional keyed junction with laser module. In another embodiment, unit includes fiber proximally joined to it, where a laser module can be added away from the fiber end, so that laser does not need to be sterilized but entire unit is safe for medical use in sterile fields. Enclosure also serves as a grip for pulling and/or manipulating device. In another preferred embodiment, laser unit is attached to a rigid delivery system for laparoscopic procedures.

A tool has a handle and an elongate shaft that extends distally from the handle. A distal portion of the shaft is inserted into a subject during a surgical procedure. An optical fiber delivers laser energy to a tip at the distal portion of the shaft. The tip includes a mechanical cutting mechanism including a moving part that absorbs the laser energy, thermally conducts the absorbed energy to tissue that is disposed between the moving part and another part, and moves with respect to the other part in order to cut tissue that is disposed between the parts using a mechanical force that is lower than a mechanical force that would be required to cut the tissue in the absence of the laser energy. Other embodiments are also described.

An instrument for endoscopic applications, including urology. The instrument may include both irrigation and aspiration channels, effective attraction and suction of tissue and body stone fragments, enhanced viewing clarity of the operational area, illumination fibers with steering function for flexible version of the scopes. In some embodiments, a distal head is configured to locate a mouth of the working channel within a viewing angle of the visualization system. In some embodiments, a transparent cap is disposed at the distal end of endoscope to provide an enhanced view of the operational area. Irrigation and aspiration channels may be arranged so that consistent water flow will attract tissue and body stone particles and remove heated liquid. Illumination fibers may be utilized as pull linkages or push-pull linkages for deflection and steering of flexible embodiments of the scope.

A side-fire laser fiber (102) includes an optical fiber (112) having a distal end (116) and a fiber cap (114). The fiber cap is coupled to the distal end of the optical fiber and includes a molded reflective surface (130) and a sealed cavity (132A or 132B). The molded reflective surface defines a wall of the cavity. Laser energy discharged from the distal end along a central axis (124) of the optical fiber is reflected off the molded reflective surface in a direction that is transverse to the central axis.

A side-fire laser fiber includes an optical fiber having a distal end and a fiber cap. The fiber cap is coupled to the distal end of the optical fiber and includes a molded reflective surface and a sealed cavity. The molded reflective surface defines a wall of the cavity. Laser energy discharged from the distal end along a central axis of the optical fiber is reflected off the molded reflective surface in a direction that is transverse to the central axis.

Composite medical treatment apparatus using skin map disclosed. The composite medical treatment apparatus includes a handpiece configured for measuring a skin condition associated with a measurement position on a region of interest in a skin map generation step, and configured for measuring a treatment position on the region of interest and applying a treatment medium according to a control parameter corresponding to the treatment position in a treatment step and a main controller configured for associating the measurement position with the skin condition in the skin map generation step, and configured for retrieving the skin condition associated with the measurement position based on the treatment position to generate the control parameter in the treatment step.