Systems, devices, and methods for identifying different structure types with distinct composition in vivo and adjusting surgical laser output accordingly in a medical procedure are disclosed. An exemplary laser treatment system comprises a laser system configured to generate a laser beam for delivery to a target in a body, and a controller circuit configured to receive a signal reflected from the target in response to electromagnetic radiation produced by a light source, and generate one or more spectroscopic properties from the reflected signal. The controller circuit can identify the target as one of a plurality of structure types, such as tissue types or calculi types with respective compositions, using the one or more spectroscopic properties. The laser system can be controlled to operate in an operating mode based on the target identification.

The present disclosure provides, according to some embodiments, methods and systems for selectively reducing, blocking or inhibiting at least part of the neural activity in an organ of a subject. In preferred embodiments, the method and system are used for selectively blocking at least part of the neural activity in a duodenum of a subject in need thereof. According to some embodiments, the selective blocking occurs through use of laser radiation. According to some embodiments, the selective blocking comprises causing damage to at least part of sensory nerves located within a target area while maintaining functional activity of tissue surrounding the sensory nerves. According to some embodiments, the sensory nerves include neurons configured to transmit signals triggered by food passing through the duodenum, such as, but not limited to, neurohormonal signals.

The present disclosure is directed towards a medical instrument. The medical instrument includes a housing and an end effector assembly operably connected to the housing. The end effector assembly includes first and second jaw members each having a tissue contacting surface, at least one of the first and second jaw members movable between a first, spaced-apart position and a second proximate position, wherein in the second position, the jaw members cooperate to define a cavity configured to receive tissue between the jaw members. The end effector also includes at least one light-emitting element coupled to at least one of the first and second jaw members, the at least one light-emitting element adapted to deliver light energy to tissue grasped between the first and second jaw members to treat the tissue.

The present disclosure relates generally to the use of medical devices for the treatment of vascular conditions. In particular, the present disclosure provides devices and methods for using laser-induced pressure waves created within a sheath to disrupt intimal and medial calcium within the vasculature.

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.

An apparatus including a light source provides for intracranial treatment of a tissue region of a brain of a patient. The intracranial treatment apparatus comprises an outer shaft having a proximal end and a distal end for positioning within the tissue region of the brain. The outer shaft defines a lumen extending between the proximal end and the distal end of the outer shaft and having at least one aperture adjacent the distal end of the outer shaft. An inner light-delivery element having a distal end and a proximal end is adapted to be operatively connected to the light source. The light-delivery element is configured to be received within the lumen and extend from the proximal end of the shaft to adjacent the distal end of the shaft. The light-delivery element is adapted to deliver light from the light source through the at least one aperture of the outer shaft to the tissue region of the brain in proximity to the distal end of the outer shaft.

The present disclosure provides, according to some embodiments, methods and systems for selectively reducing, blocking or inhibiting at least part of the neural activity in an organ of a subject. In preferred embodiments, the method and system are used for selectively blocking at least part of the neural activity in a duodenum of a subject in need thereof. According to some embodiments, the selective blocking occurs through use of laser radiation. According to some embodiments, the selective blocking comprises causing damage to at least part of sensory nerves located within a target area while maintaining functional activity of tissue surrounding the sensory nerves. According to some embodiments, the sensory nerves include neurons configured to transmit signals triggered by food passing through the duodenum, such as, but not limited to, neurohormonal signals.

A catheter system for imparting pressure to induce fractures at a treatment site within or adjacent a blood vessel wall includes a catheter, a fortified balloon inflation fluid and a first light guide. The catheter includes an elongate shaft and a balloon that is coupled to the elongate shaft. The balloon has a balloon wall and can expand to a first expanded configuration to anchor the catheter in position relative. The fortified balloon inflation fluid can expand the balloon to the first expanded configuration. The fortified balloon inflation fluid includes a base inflation fluid and a fortification component. The fortification component reduces a threshold for inducing plasma formation in the fortified balloon inflation fluid compared to the base inflation fluid. The fortification component can include at least one of carbon and iron. The first light guide is disposed along the elongate shaft and is positioned at least partially within the balloon. The first light guide is in optical communication with a light source and the fortified balloon inflation fluid. The light source provides sub-millisecond pulses of a light to the first light guide so that plasma formation and rapid bubble formation occur in the fortified balloon inflation fluid, thereby imparting pressure waves upon the treatment site.

A catheter system includes a catheter having an elongate shaft, a balloon and a light guide. The balloon expands from a collapsed configuration to a first expanded configuration. The light guide is disposed along the elongate shaft and is in optical communication with a light source and a balloon fluid. A first portion of the light guide extends into a recess defined by the elongate shaft. A protection structure is disposed within the recess and is in contact with the first portion of the light guide. The light source provides pulses of light to the balloon fluid, thereby initiating plasma formation and rapid bubble formation within the balloon, thereby imparting pressure waves upon a treatment site. The protection structure can provide structural protection from the pressure waves to the first portion of the light guide.

A catheter system for pressure wave and inertial impulse generation for intravascular lesion disruption at a treatment site includes a catheter including an elongate shaft and balloon coupled to the elongate shaft. The catheter system includes a light guide disposed along the elongate shaft and at least partially within the balloon, where the light guide is in optical communication with a light source and a balloon fluid. The catheter can include a first focusing element located at a distal portion of the light guide and in optical communication with the light source. The first focusing element can direct light from within the light guide to a first location at a first distance away from the distal portion of the light guide to initiate plasma formation in the balloon fluid away from the distal portion and to cause rapid bubble formation, thereby imparting pressure waves at the treatment site.