A side fire optical fiber tip is provided for use in high power laser applications having outputs of greater than or equal to 50 Watts. A predetermined length of an output tip on the distal end of the optical fiber is formed with an optical fiber core and cladding layer of preselected thickness wherein the cladding to core diameter ratio is at least as great as 1.2. A side fire surface is formed on the distal end of the core/clad output end. Over this optical fiber output end, a pure silica capillary tube is fused to the predetermined length of exposed cladding where the outermost cladding is also pure silica to reduce thermal mismatch during the fusion process. By having the refractive index at the fusing interface matched, and bubbles or gaps eliminated or prevented, it is possible to substantially eliminate Fresnel reflection losses at this interface.

A method for treating a treatment site within a body of a patient with a catheter system includes generating energy with an energy source; positioning an inflatable balloon substantially adjacent to the treatment site, the inflatable balloon having a balloon wall that defines a balloon interior that receives a balloon fluid; receiving energy from the energy source with an energy guide; guiding the energy with the energy guide into the balloon interior; sensing acoustic sound waves generated in the balloon fluid with an acoustic sensor that is positioned outside of the body of the patient; generating a sensor signal with the acoustic sensor based at least in part on the sensed acoustic sound waves; electrically coupling a system controller to the acoustic sensor; receiving the sensor signal from the acoustic sensor with the system controller; and controlling operation of the catheter system with the system controller based at least in part on the sensor signal, the system controller being configured to recognize one of: (i) normal operation of the catheter system, and (ii) potential damage to the energy guide.

A probe of a target identification system can be extended via a first lumen of a viewing instrument, such as for illuminating an area beyond a distal end of the viewing instrument via an optical path of the viewing instrument. An optical response to the illumination of the area can be received via an optical path of the probe and can be split from other optical signals of the optical path. The optical response information can be used to identify characteristics of a target and to adjust parameters of a working instrument such as a working instrument contemporaneously using the probe.

A probe of a target identification system can be extended via a first lumen of a viewing instrument, such as for illuminating an area beyond a distal end of the viewing instrument via an optical path of the viewing instrument. An optical response to the illumination of the area can be received via an optical path of the probe and can be split from other optical signals of the optical path. The optical response information can be used to identify characteristics of a target and to adjust parameters of a working instrument such as a working instrument contemporaneously using the probe.

A catheter system for pressure wave and inertial impulse generation for intravascular lesion disruption includes a balloon coupled to an elongate shaft, and a first and second light guide disposed along the elongate shaft. The first and second light guides each include a diverting feature in optical communication with at least one light window to direct light to exit each light guide toward a side surface portion thereof and toward the balloon. A method includes expanding the balloon from a collapsed configuration to a first expanded configuration, and activating a light source in optical communication with each light guide to provide sub-millisecond pulses of light to the diverting features, thereby inducing plasma formation in a balloon fluid, causing rapid bubble formation, and 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 vascular lesion. The protection structure can provide structural protection from the pressure waves to the first portion of the light guide.

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 occurs through use of ultrasound energy. 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 by means of shielding it from the effects of laser radiation. 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.

A probe of a target identification system can be extended via a first lumen of a viewing instrument, such as for illuminating an area beyond a distal end of the viewing instrument via an optical path of the viewing instrument. An optical response to the illumination of the area can be received via an optical path of the probe and can be split from other optical signals of the optical path. The optical response information can be used to identify characteristics of a target and to adjust parameters of a working instrument such as a working instrument contemporaneously using the probe.

An ablation instrument (e.g., an ablation balloon catheter system) includes an elongate catheter having a housing with a window formed therein. An energy emitter is coupled to the elongate catheter and is configured to deliver ablative energy. A controller is received within the window and is coupled to the energy emitter such that axial movement of the controller within the window is translated to axial movement of the energy emitter and rotation of the controller within the window is translated into rotation of the energy emitter. The instrument includes a motor that is at least partially disposed within the housing of the catheter; a first gear that is operatively connected to and driven by the motor; and a second gear that is coupled to the energy emitter and is driven by the first gear to cause rotation of the energy emitter, while allowing the energy emitter to move axially.