Maintenance of a steam bubble during surgical ablation
View Patent ↗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.
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 ablation of the surgical target.
2. The surgical method of claim 1 , wherein the continuous-wave laser emission is diverging 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 a 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 shorter 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 4° off a longitudinal axis of the optical fiber.
9. The surgical method of claim 1 , wherein establishing the steam bubble includes providing at least one of the continuous-wave laser emission and the therapeutic laser emission to water disposed 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 said 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 said 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 said maintaining the steam bubble prevents a reduction of a 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 couple 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 4 degrees;
wherein the low-angle and high-angle of respective launches are measured 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 of laser diodes or diode-pumped solid-state lasers, the continuous-wave laser emission source having an emissions wavelength of 1930±30 nm.
20. The surgical device of claim 17 , wherein
the surgical device is configured to carry the continuous-wave laser emission in the fluorine-doped silica cladding.