A system and method for detecting relative location of a surgical laser fiber tip relative to a surgical laser target during a surgical laser procedure utilizes a spectrophotometer to detect radiation indicative of the relative location. For example, the detected radiation may indicate contact between the fiber tip and a stone being subjected to laser lithotripsy, so as to prompt the surgeon to withdraw the fiber tip from the stone and/or take other action to limit contact-induced erosion of the fiber tip, and to avoid saturation of the endoscope camera resulting from the flash that occurs following contact. In addition, the absence of any detected radiation by the spectrophotometer may be used to indicate that the stone is no longer present, or that the fiber tip is no longer aimed at the stone, prompting the operator to reposition the fiber and/or temporarily cease firing of the laser. The main surgical laser may be a pulsed Holmium laser, which is delivered to the target through the optical fiber together with a pulsed 532 nm aiming beam.

A side-firing laser system with a standoff catheter includes an optical fiber configured to emit therapeutic laser radiation in a direction generally transverse to an axis of the fiber; and a catheter through which the optical fiber is inserted during a surgical procedure. The catheter includes a transparent end section through which the therapeutic laser radiation passes to vaporize tissue outside the catheter, an open distal end to permit exit of irrigation fluid from the catheter, and an opening in a side of the end section, the opening having dimensions that are approximately equal to or less than cross-sectional dimensions of the therapeutic laser radiation. When the fiber is moved to a position at which the therapeutic laser radiation passes through the opening, the laser radiation causes coagulation or vaporization of tissues.

A reverse retropulsion device can include a lithotripter, a collection passage, and an energy directing device. The lithotripter can be configured to deliver energy to tissue located at a tissue forming region. The collection passage can be positionable at or near the body lumen. The energy directing device can be positionable near the lithotripter and the collection passage. The energy directing device can be configured to propel the tissue toward the collection passage.

A catheter system for treating a vascular lesion within or adjacent to a vessel wall includes an energy source, a plurality of energy guides and a system controller. The energy source generates energy. The plurality of energy guides receive energy from the energy source. The system controller controls the energy source so that the energy is sequentially directed to each of the plurality of energy guides in an advancing wavefront. The system controller controls a firing rate of the energy source to each of the plurality of energy guides. The system controller can control a firing sequence to the plurality of energy guides so that the advancing wavefront is generated toward the vascular lesion from near the balloon proximal end and from near the balloon distal end. The system controller can control the energy source so that light energy from the energy source is alternatively directed to at least two of the plurality of energy guides at a different firing energy level from one another. The energy level can be based on pulse width, wavelength and/or amplitude of the energy pulse(s).

The present invention is directed toward a method for treating a vascular lesion within or adjacent to a vessel wall. The method includes the steps of generating energy with an energy source; receiving the energy with a plurality of energy guides; and controlling the energy source with a system controller of a catheter system so that the energy from the energy source is sequentially directed to each of the plurality of energy guides in a first firing sequence. The method can include the system controller controlling a firing rate of the energy source to each of the plurality of energy guides. The method can include the system controller controlling a firing sequence to the plurality of energy guides so that an advancing wavefront is generated toward the vascular lesion from near a balloon proximal end and/or from near a balloon distal end. The system controller can control a firing energy level, which can be dependent at least partially upon the pulse width, the wavelength and/or the amplitude of the energy pulses.

A catheter system for treating a treatment site within or adjacent to a vessel wall includes a light source, a balloon, a light guide, and an optical analyzer assembly. The light source generates light energy. The balloon is positionable substantially adjacent to the vascular lesion. The balloon has a balloon wall that defines a balloon interior that receives a balloon fluid. The light guide receives light energy from the light source at a guide proximal end and guides the light energy toward a guide distal end and into the balloon interior. The optical analyzer assembly is configured to optically analyze light energy emitted from the guide proximal end of the light guide.

A method for treating a treatment site within or adjacent to a vessel wall or a heart valve, includes the steps of (i) generating light energy with a light source; (ii) positioning a balloon substantially adjacent to the treatment site, the balloon having a balloon wall that defines a balloon interior that receives a balloon fluid; (iii) receiving the light energy from the light source with a light guide at a guide proximal end; (iv) guiding the light energy with the light guide in a first direction from the guide proximal end toward a guide distal end that is positioned within the balloon interior; and (v) optically analyzing with an optical analyzer assembly light energy from the light guide, wherein the light energy that is analyzed moves in a second direction that is opposite the first direction.

In one embodiment, the disclosure is directed to an integrated apparatus for delivering energy to a tissue. The integrated apparatus included a housing having a distal end and a tubular structure located within the housing forming a first annulus between the tubular structure and the housing. The tubular structure is configured to accept an energy delivery component and is configured to form a second annulus between the tubular structure and the energy delivery component. The first annulus and the second annulus are configured to communicate with each other proximate to the distal end of the housing.

A medical instrument includes two jaw members, at least one of which creates conditions of frustrated total internal reflection at a tissue-contacting surface when tissue is grasped between the two jaw members. The first jaw member may include an optical element having a tissue-contacting surface. The medical instrument also includes a light source that provides a light beam for sealing tissue. The light source is positioned so that the light beam is totally internally reflected from an interface between the tissue-contacting surface and air when tissue is not grasped by the jaw members. When tissue is grasped by the jaw members, at least a portion of the light beam is transmitted through that portion of the tissue-contacting surface that is in contact with the tissue. The light source may be movably coupled to a jaw member to scan the light beam and/or to change the incident angle based on optical properties of the tissue.

A light radiating device (1A) performs solidification or cauterization of a biological tissue (PL) by radiating a light beam (BM). A light source (10A) emits the light beam (BM). An optical waveguide (20A) is a member being provided with a reflection surface (21A) totally reflecting the light beam (BM) on an inner circumferential side wall, causing the light beam (BM) emitted from the light source (10A) to enter a part enclosed by the inner circumferential side wall from one end, and sending the light beam (BM) to the other end. A catoptric system (30A) reflects the light beam (BM) sent to the other end of the optical waveguide (20A) and condenses the light beam (BM) on the biological tissue (PL).