Method and system for vaporization of tissue using direct visualization

1 . A method for vaporizing benign hyperplastic prostate tissue under direct visualization, comprising:

generating electromagnetic radiation;

applying the generated electromagnetic radiation to the prostate tissue to cause vaporization of tissue, wherein the electromagnetic radiation has an irradiance in the treatment area greater than 10 kilowatts/cm 2 in a spot size at least 0.05 mm 2 ; and

directly viewing the prostate tissue while applying the generated electromagnetic radiation in order to observe the vaporization.

2 . The method of claim 1 , wherein the light comprises output of a laser with a wavelength between 300 and 700 nm without the use of general anesthesia or spinal nerve blocks.

3 . The method of claim 1 , wherein the light comprises output of a laser with a wavelength between 500 and 550 nm without the use of general anesthesia or spinal nerve blocks.

4 . The method of claim 1 , wherein the light comprises output of a laser with a wavelength between 1100 and 1800 nm without the use of general anesthesia or spinal nerve blocks.

5 . The method of claim 1 , wherein the light comprises output of a laser with an average power greater than 40 watts and wavelength between 300 and 700 nm without the use of general anesthesia or spinal nerve blocks.

6 . The method of claim 1 , wherein the light comprises output of a laser with an average power greater than 40 watts and wavelength between 500 and 550 nm without the use of general anesthesia or spinal nerve blocks.

7 . The method of claim 1 , wherein the light comprises output of a laser with an average power greater than 40 watts and wavelength between 1100 and 1800 nm without the use of general anesthesia or spinal nerve blocks.

8 . A method for vaporizing tissue under direct visualization, comprising:

delivering electromagnetic radiation to a treatment area on the tissue, the electromagnetic radiation having a wavelength and having irradiance in the treatment area sufficient to cause vaporization of a substantially greater volume of tissue than a volume of residual coagulated tissue caused by the laser radiation;

moving the electromagnetic radiation in the treatment area; and

directly viewing the tissue while applying and moving the generated electromagnetic radiation in order to observe the vaporization.

9 . The method of claim 1 , wherein said tissue comprises prostate gland tissue, and said delivering comprises using a transurethral cystoscope, with an optical fiber adapted to direct electromagnetic radiation from the fiber to the treatment area.

10 . The method of claim 8 , wherein said delivering comprises using a transurethral cystoscope, with an optical fiber having a side firing optical element directing electromagnetic radiation from the fiber to the treatment area, and placing said side firing optical element within about 1 mm, or less, of the treatment area.

11 . The method of claim 8 , wherein said tissue comprises prostate gland tissue, and said delivering comprises using a transurethral cystoscope, and further including applying only local anesthetic during said delivering.

12 . The method of claim 8 , including determining an endpoint for said delivering based on said direct viewing.

13 . The method of claim 8 , including delivering a flow of irrigant to the treatment area.

14 . The method of claim 8 , wherein said electromagnetic radiation is visible.

15 . The method of claim 8 , wherein said tissue comprises prostate gland tissue.

16 . The method of claim 8 , including generating said electromagnetic radiation using a solid state laser with greater than 60 Watts average output power.

17 . The method of claim 8 , wherein said directly viewing includes using a video camera.

18 . The method of claim 8 , wherein said tissue comprises prostate gland tissue, and said delivering comprises applying only local anesthetic during said delivering.