Maintenance of a Steam Bubble During Surgical Ablation

• US 20190336216A1
• Filed: 05/03/2018
• Published: 11/07/2019
• Est. Priority Date: 05/03/2018
• Status: Active Grant

• Current Assignee: Cyclone Biosciences LLC
• Original Assignee: InnovaQuartz, LLC
• Inventors: Griffin, Stephen E.
• Granted Patent: US 10,639,102 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 18/26 for producing a shock wave, e.g. laser lithotripsy
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/206 the laser light passing along a liquid-filled conduit
• CPC Class Codes: A61B 2018/2222 Fibre material or composition
• CPC Class Codes: A61B 2018/263 the conversion of laser energy into mechanical shockwaves taking place in a liquid
• CPC Class Codes: G02B 6/02033 Core or cladding made from organic material, e.g. polymeric material G02B1/04 takes precedence
• CPC Class Codes: G02B 6/02047 Dual mode fibre G02B6/105 takes precedence
• CPC Class Codes: G02B 6/262 Optical details of coupling light into, or out of, or between fibre ends, e.g. special fibre end shapes or associated optical elements
• CPC Class Codes: G02B 6/4296 coupling with sources of high radiant energy, e.g. high power lasers, high temperature light sources

Abstract

A surgical method and tool for establishing a steam bubble between a fiber tip and a surgical target. The device and process capable of maintaining the steam bubble by providing a low-power, continuous-wave laser emission. Furthermore, the method and tool capable of delivering to the surgical target through the steam bubble a therapeutic laser emission providing ablation of the surgical target.

Claims

1. A surgical method comprising:

establishing a steam bubble between a fiber tip and a surgical target;

maintaining the steam bubble by providing a low-power, continuous-wave laser emission; and

then

delivering to the surgical target through the steam bubble a therapeutic laser emission;

wherein the therapeutic laser emission provides the ablation of the surgical target.

2. The surgical method of claim 1, wherein the continuous-wave laser emission has a divergent emission from the fiber tip.

3. The surgical method of claim 1, wherein the continuous-wave laser emission has an annular beam profile.

4. The surgical method of claim 1, wherein the continuous-wave laser emission has an emissions wavelength of 1930±

30 nm and a power output of less than 5 Watts.

5. The surgical method of claim 1, wherein the therapeutic laser emission has a wavelength greater than 1960 nm and a power output of greater than 10 Watts.

6. The surgical method of claim 1, wherein the therapeutic laser emission has a wavelength less than 500 nm.

7. The surgical method of claim 1, wherein the continuous-wave laser emission and the therapeutic laser emission are provided via an optical fiber having a fused silica core, the fused silica core clad with a fluorine doped silica cladding, the fluorine doped silica cladding having a polymer cladding;

wherein the therapeutic laser emission is contained within the fused silica core by the fluorine doped silica cladding.

8. The surgical method of claim 7, further comprising providing the continuous-wave laser emission to the optical fiber with a high-angle launch of greater than about 4°

off the fiber longitudinal axis.

9. The surgical method of claim 1, wherein establishing the steam bubble includes providing the continuous-wave laser emission and/or the therapeutic laser emission to water positioned between the fiber tip and the surgical target.

10. The surgical method of claim 9, wherein the continuous-wave laser emission has an annular beam profile, and wherein the steam bubble is established by therapeutic laser emission.

11. The surgical method of claim 1, wherein a volume of the steam bubble changes less than 50 vol. % while delivering the therapeutic laser emission to the surgical target.

12. The surgical method of claim 1, wherein the method provides a single steam bubble.

13. The surgical method of claim 1, wherein the steam bubble is adjacent to the surgical target.

14. The surgical method of claim 1, wherein maintaining the steam bubble reduces retropulsion.

15. The surgical method of claim 1, wherein the therapeutic laser emission has a power output of greater than 10 Watts at the fiber tip;

and wherein maintaining the steam bubble prevents a reduction of the power output between the fiber tip and the surgical target.

16. A surgical device comprising:

a therapeutic laser emission source having a power output of greater than 10 Watts;

a continuous-wave laser emission source having a power output of less than 5 Watts;

a low angle therapeutic laser emission launch adapted to provide a therapeutic laser emission to a core of an optical fiber; and

a high angle continuous-wave laser emission launch adapted to provide a continuous-wave laser emission to the optical fiber with a launch angle of greater than about 4°

;

wherein the low-angle and high-angle of the respective launches are with respect to a longitudinal axis of the optical fiber.

17. The surgical device of claim 16 further comprising the optical fiber having a fused silica core, the fused silica core clad with a fluorine doped silica cladding, the fluorine doped silica cladding having a polymer cladding.

18. The surgical device of claim 16, wherein the therapeutic laser emission source is a holmium laser or a thulium laser.

19. The surgical device of claim 16, wherein the continuous-wave laser emission source is one or more laser diodes or diode-pumped solid-state lasers, the emission source having an emissions wavelength of 1930±

30 nm.

20. The surgical device of claim 17, wherein the high angle continuous-wave laser emission launch adapted to provide a continuous-wave laser emission to the optical fiber with a launch angle of greater than about 4°

, wherein the launch and launch angle are adapted carry the continuous-wave laser emission in the fluorine doped silica cladding.