A device for performing a surgical procedure can comprise a shaft extending from a proximal portion to a distal portion, a light conductor extending at least partially through the shaft to be exposed at the distal portion, and a damage mitigator positioned to receive light from the light conductor to discharge the light from the device. A method of preventing damage to an optical fiber in a medical device having laser treatment capabilities can comprise emitting a laser beam from the optical fiber, fragmenting a biological stone with the laser beam, and mitigating damage to the optical fiber from fragmentation of the biological stone.

The application relates to a cleaning system configured for cleaning of cavities filled with a liquid, including fragmentation, debridement, material removal, irrigation, disinfection, and decontamination. The cleaning system includes an electromagnetic radiation system and a liquid. A treatment handpiece irradiates the liquid within a cavity with a radiation beam, producing a first vapor bubble using first pulse, and, at a different location, a second vapor bubble using a second pulse. The pulse repetition time is adjusted to ensure efficacy, for example such that an onset time of the second vapor bubble is within the first contraction phase of the first vapor bubble, when the first vapor bubble has contracted from its maximal volume to a size in a range from about 0.7 to about 0.1 of the maximal volume.

An energy director (1055) for a catheter system (100) for treating a treatment site (106) within or adjacent to a vessel wall (108A) or heart valve within a body (107) of a patient (109). The catheter system (100) includes an energy source (124) that generates energy, a balloon (104) having a balloon distal region (1004DR) that has a varying diameter, and a balloon proximal region (1004PR) having a substantially constant diameter, and an energy guide (122A) including a guide distal end (122D), the energy guide (122A) being configured to receive the energy from the energy source (124). The energy director (1055) can include a guide sleeve (1057) that is secured to the energy guide (122), the guide sleeve at least partially (1057) encircling the guide distal end (122D) of the energy guide (122A). The guide sleeve (1057) extends distally from the guide distal end (122D) in a direction toward the balloon distal region (1004DR).

The presently disclosed subject matter provides techniques for inducing collagen cross-linking in human tissue, such as cartilage, by inducing ionization of the water contained in the tissue to produce free radicals that induce chemical cross-linking in the human tissue. In an embodiment, a femtosecond laser operates at sufficiently low laser pulse energy to avoid optical breakdown of the tissue being treated. In an embodiment, the femtosecond laser operates in the infrared frequency range.

A method of reducing retro-repulsion of a stone during a laser lithotripsy procedure involves the use of a spacer tip or standoff sleeve to create a passage between the tip of a fiber and a stone, and to prevent collapse of a bubble formed by vaporization of and/or gas pressure on liquid present in the passage. The laser radiation may consist of continuous or quasi-continuous wave radiation that is relatively low in power compared to the therapeutic pulses, or may consist of the therapeutic pulses if the pulse frequency is high enough to prevent collapse of the bubble between pulses. The spacer tip or standoff sleeve further prevents collapse of the bubble and ingress of liquid into the laser path. The spacer tip or standoff sleeve may be a generally-cylindrical protective cap that is fitted to an end of the optical fiber and that extends beyond the fiber tip to provide a predetermined spacing or standoff between the fiber tip and the stone when the protective cap is in contact with the stone. Alternatively, the spacer tip or standoff sleeve may be a catheter sleeve that permits axial adjustment of fiber position within the sleeve.

Apparatus for the treatment of a target tissue with a laser beam in which the target tissue is immersed in a liquid medium within a body lumen. The laser device is configured to provide one or more laser pulses which are configured by a controller to have an energy sufficient to form one or more vapor bubbles in the liquid medium at the distal delivery end of the fiber. The one or more pulses are configured by the controller to: first, cause a vapor bubble to be formed distally of the distal end portion of the endoscope and around the distal delivery end of the optical fiber; second, cause a second bubble to be formed distally of the first bubble; and, third, inflate the second bubble as the first bubble has begun to collapse to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the distal delivery end of the fiber and the target tissue.

A method and apparatus for chemically treating a cataract in the eye of a patient comprising the steps of (a) inserting a dual lumen work tip into the eye and placing it adjacent the cataract tissue; (b) causing the work tip to vibrate so that pieces of the cataract separate or emulsify; (c) moving the work tip into the cataract tissue so as to form a tunnel therein; and (d) injecting into the tunnel a pharmaceutical compound capable of treating cataract tissue.

Systems and methods for treating tissue by directing light pulses using bubbles generating in tissue using previously transmitted light pulses are disclosed. Systems and methods for treating tissue using a lens array comprising a pitch or separation distance sized to overlap sonoporation induced shockwaves are also disclosed. In one embodiment, the shockwaves are generated in response to incident light pulses directed through adjacent lenses in the array. Systems and methods can improve porosity of the cellular membrane. Systems and methods for creating channels in tissue by using stacked pulses are also disclosed.

A method of treating a mobile target tissue with a laser beam includes: providing a laser device for generating a laser beam and providing an optical fiber having a delivery end for guiding the laser beam to the target tissue; a controller causes the laser device to generate one or more laser pulses substantially along the same longitudinal axis. The controller causes the laser device to provide one or more laser pulses. The one or more pulses are selected to allow a vapor bubble formed by the one or more pulse to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the delivery end of the fiber and the target tissue. The one or more pulses are delivered to the target tissue through the vapor bubble after the vapor bubble has reached its maximum extent and has begun to collapse to reduce retropulsion of the mobile target tissue.

Provided is a surgical handpiece for providing an electromagnetic cutting blade. The handpiece, comprises a body portion having an input end and an output end, a plurality of optical fibers for receiving laser energy having a wavelength within a predetermined wavelength range, wherein the optical fibers are received in the body portion at the input end and extend to the output end, and an optical fiber transition region within the body portion for arranging the plurality of optical fibers into a predetermine cutting shape at the output end, wherein laser energy transmitted from the arranged optical fibers at the output end interact with water molecules near the surgical target to generate micro-explosions that result in a cutting effect.