Other

Optical Integrity, Inc.

Angiodynamics, Inc.

Joe Denton Brown

Daniel Malphurs

Howard S Klymas

William M Appling

William C Hamilton

Theodore J Beyer

Ralph A Meyer

Michael E Haarlander

Thomas M Haarlander

Ira Brown

Diane S Brown

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.

Side-fire laser system with stand-off catheter, standoff catheter, and method of using surgical laser to achieve both tissue vaporization and rapid coagulation to prevent or halt bleeding

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.

Stone sense with fiber erosion protection and camera saturation prevention, and/or absence-detection safety interlock

A protective structure for the distal treatment end of a surgical laser fiber inserted into a patient through a scope includes uniformly-spaced ruler or scale markings that are visible through the scope and that enable the size of an object within the field of view of the scope to be precisely determined.

Fiber tip protective structure with scale indicator

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.

Method of reducing retro-repulsion during laser lithotripsy

A distal end of an optical fiber may be protected by a variety of alternative protective caps, tips, and/or sleeves. In one example, a generally cylindrical soft tip is arranged to fit over the end of the fiber, and to compress in an axial direction when pressed against a stone to allow a recessed tip of the fiber to contact the stone or to be maintain a minimum spacing between the fiber tip and the stone and thereby limit erosion of the fiber tip.

Protective caps of tips for surgical laser fibers

An arrangement that prevents carbonization of cladding, coating, or buffer layers of a surgical laser fiber due to thermal radiation reflected back into the fiber from, or emitted by, a target of the laser, includes a thermal radiation blocking, absorbing or diverting structure. The thermal radiation blocking, absorbing or diverting structure surrounds an end portion of the fiber that has been stripped of one or more coating and/or buffer layers, and may be made of a heat resistant material such as PTFE or polyimide to block heat from reaching the coating or buffer layers, an optical ferrule such as fused silica to guide the heat away from the fiber coating or buffer layers, or a high refraction index material such as UV adhesive.

Arrangement for filtering out damaging heat created from laser energy contacting a kidney stone

A protective ferrule for an end-firing optical fiber arrangement combines a spherical or rounded shape with a planar end. The combination of the spherical or rounded shape and planar end provides protection for the working channel of an endoscope or catheter through which the fiber is inserted while confining and minimizing erosion of the active surface area of the fiber. The protective ferrule of may be fitted to the end of the optical fiber by the steps of heating the ferrule to expand an inside diameter so that it fits over the end of the fiber, with subsequent cooling of the ferrule causing it to contract and create a compression fit.

End fire fiber arrangements with improved erosion resistance

An optical fiber includes an integrated detector in the form of phosphors that emit light of a characteristic frequency or wavelength in response to leakage, through the fiber cladding, of light having an interrogation wavelength &#x3bb;. Stimulation of phosphor emission by the interrogation light is indicative of aging or wear on the layers surrounding the cladding, and therefore can be used to assess the risk of imminent breakage of the fiber.

Optical fiber that provides an indication that breakage is imminent, and method of manufacturing such as fiber

A protective sheath is provided to prevent mechanical damage to the working channel of the endoscope during insertion of the fiber, insulate the fiber from surrounding cooling fluids, and/or serve as an indicator of overheating that enables early detection of excess heating or burning of tissues or equipment at the treatment site. The protective sheath may include trim markings to facilitate cutting to a desired length, such as the length of the fiber in the scope, may also be arranged to glow when the fiber is pulled too far into the sheath, may be tightly fitted over the fiber to provide a plunger effect, and may include perforations to facilitate sterilization.

Protective sheath and method of using same for laser surgery

An endovascular laser treatment device for causing closure of a blood vessel uses an optical fiber adapted to be inserted into a blood vessel. An inner sleeve is arranged around a distal portion of the optical fiber core such that both distal ends of the inner sleeve and the optical fiber core form an enlarged light emitting face. The enlarged emitting face provides substantially lower power density while providing the same amount of total energy during a treatment session. An outer sleeve arranged around the inner sleeve acts as a spacer to position the light emitting face away from an inner wall of the blood vessel. The enlarged light emitting face and the outer sleeve acting as a spacer reduces the possibility of thermal run-away and device damage, and reduce the possibility of vessel perforations, leading to less bruising, post-operative pain and other clinical complications. In yet another aspect of the present invention, a spacer comprises an inner sleeve and an outer sleeve both arranged around a distal portion of the core to prevent the laser light from traveling laterally and to position the light emitting face away from an inner wall of the vessel. The inner sleeve can be a heat resistive material such as ceramic and the outer sleeve can be, for example, a metallic sleeve to provide structural integrity and strength to the distal section of the treatment device.

Method of making an endovascular laser treatment device for causing closure of a blood vessel

An end-firing optical fiber includes protective ferrule through which treatment radiation is fired in an axial direction, the protective ferrule having refractive properties that cause the radiation to disperse laterally and/or the fiber having sufficient flexibility to enable the fiber to be aimed at a tissue situated to the side of the axis along which the fiber was inserted. The fiber and protective ferrule may be mounted in a cannula, with the cannula being sufficiently flexible to enable the cannula to be withdrawn into a scope having a straight working channel, but has a pre-formed curvature that enables treatment of lateral tissues when the cannula is extended out of a scope.

A method and apparatus for detecting excess absorption of therapeutic radiation at a bend in a fiber, and the possibility of imminent fiber failure, by monitoring stimulated radiation emission by phosphors in a coating of the fiber, the stimulated emission being caused by leakage of an aiming beam through the cladding into the coating. To accomplish the detection, a conventional monitoring method and equipment are modified to detect the absence of, or an interruption in, the stimulated emission, which is caused by separation of the coating from the cladding in the area of the bend as a result of the excess absorption.

Monitoring method and apparatus for surgical laser fibers

A medical laser safety feedback apparatus and method enhances the detectability of a feedback signal from the treatment site by modulating or encoding an aiming or reference beam that is used to provide a stimulated emission or reflected component of the feedback signal.

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Panama City Beach, FL, United States of America

Joe Denton Brown