A probe is configured with a flushing port and an evacuation port to establish a flow path to remove blood from a resected tissue. The probe comprises a balloon configured to expand and contact the resected tissue to compress filaments and improve access to the underlying blood vessels for coagulation with an energy source. An endoscope can be used to view the tissue, and the balloon may comprise a transparent material or a viewing port to allow imaging of the bleeding tissue through the balloon. The probe may have a light source to illuminate the tissue with a beam oriented at an oblique angle to the tissue surface, which can decrease interference from blood and may allow more localized coagulation of the blood vessel.

A laser fiber for use in performing a medical laser treatment includes an optical fiber and a fiber tip. The optical fiber includes a terminating end surface at a distal end. The fiber tip is positioned at the distal end of the optical fiber and includes a transmissive portion and a spacer portion. Laser energy discharged from the terminating end surface of the optical fiber is transmitted through the transmissive portion. The spacer portion defines a distal terminating end of the fiber tip that is spaced a predetermined distance from the terminating end surface of the optical fiber. The predetermined distance is set for shock wave generation for calculus destruction at the distal terminating end of the fiber tip.

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.

A fluid stream is directed toward tissue to generate a plurality of shedding clouds. The fluid stream can be scanned such that the plurality of shedding clouds arrive a different overlapping locations. Each of the plurality of shedding clouds can remove a portion of the tissue. In many embodiments, an apparatus to ablate tissue comprises a source of pressurized fluid, and a nozzle coupled to the source of pressurized fluid to release a fluid stream, in which the fluid stream generates a plurality of shedding clouds.

Multi-fiber laser probes utilize relative motion of fibers and other laser probe elements to preserve small-gauge compatibility while providing for multi-spot beam deliver, or to provide for the selectively delivery of single-spot or multi-spot beam patterns. An example probe includes fibers having distal ends that are movable as a group onto a distal ramp element affixed to a distal end of a cannula, so that the distal ends of the fibers can be moved between a retracted position, in which the distal ends of the fibers are within the cannula or ramp element, and an extended position, in which distal ends of the fibers are guided by grooves or channels of the ramp so as to extend at least partially through external openings in the distal end of the laser probe and so as to be pointed angularly away from a longitudinal axis of the cannula.

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.

A device configured to cut hair using laser light includes a handle portion and a shaving portion. The handle portion includes a battery and a laser light source. The laser light source is coupled to and configured to receive power from the battery. The laser light source is also configured to generate laser light having a wavelength selected to target a predetermined chromophore to effectively cut a hair shaft. The shaving portion includes a support and a single fiber optic supported by the support. The fiber optic has a proximal end, a distal end, an outer wall, and a cutting region positioned towards the distal end and extending along a portion of the side wall. The fiber optic is positioned to receive the laser light from the laser light source at the proximal end, conduct the laser light from the proximal end toward the distal end, and emit the light out of the cutting region and toward hair when the cutting region is brought in contact with the hair.

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.

A steerable laser probe may include a handle having a handle proximal end and a handle distal end, an actuation structure of the handle, a housing sleeve, a shape memory sleeve at least partially disposed within the housing sleeve, and an optic fiber disposed within the shape memory sleeve and within an inner bore of the handle. A compression of the actuation structure may be configured to gradually curve the optic fiber. A compression of the actuation structure may be configured to gradually straighten the optic fiber. A decompression of the actuation structure may be configured to gradually curve the optic fiber. A decompression of the actuation structure may be configured to gradually straighten the optic fiber.

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.