Method and system for photoselective vaporization of the prostate, and other tissue

Abstract

A method for photoselective vaporization of prostate tissue includes delivering laser radiation to the treatment area on the tissue, via an optical fiber secured using a card key, wherein the laser radiation has a wavelength and irradiance in the treatment area on the surface of the tissue sufficient because vaporization of a substantially greater volume of tissue than a volume of residual coagulated tissue caused by the laser radiation. The laser radiation is generated using a neodymium doped solid-state laser, including optics producing a second or higher harmonic output with greater than 20 watts average output power. The delivered laser radiation has a wavelength for example in a range of about 200 nm to about 650 nm, and has an average irradiance in the treatment area greater than about 10 kilowatts/cm 2 , in a spot size of at least 0.05 mm 2 .

1 . A method for photoselective vaporization of tissue, comprising: 
 coupling an optical fiber to a laser system;    enabling the laser system using a secure card key interface;    producing laser radiation using the laser system; and    delivering said laser radiation using the optical fiber to a treatment area on a surface of the tissue, the laser radiation having a wavelength in a range from about 200 to about 1000 nm and having average irradiance in the treatment area sufficient for removal of tissue.    
   
   
       2 . The method of  claim 1 , including delivering said laser radiation endoscopically  
   
   
       3 . The method of  claim 1 , wherein the wavelength is about 532 nm.  
   
   
       4 . The method of  claim 1 , wherein oxyhemoglobin is a primary chromophore of said tissue.  
   
   
       5 . The method of  claim 1 , wherein said tissue comprises prostate tissue.  
   
   
       6 . The method of  claim 1 , the laser radiation being absorbed substantially completely by the tissue within about 1 mm of the surface, and having average irradiance in the treatment area greater than 10 kiloWatts/cm 2  in a spot size at least about 0.05 mm 2 .  
   
   
       7 . The method of  claim 1 , the laser radiation being absorbed substantially completely by the tissue within about 1 mm of the surface, and having average irradiance in the treatment area greater than 10 kiloWatts/cm 2  in a spot size between about 0.1 and 0.8 mm 2  in the treatment area.  
   
   
       8 . The method of  claim 1 , the laser radiation being absorbed substantially completely by the tissue within about 1 mm of the surface, and having average irradiance in the treatment area greater than 30 kiloWatts/cm 2  in the treatment area.  
   
   
       9 . The method of  claim 1 , wherein the delivered laser radiation has an average irradiance in the treatment area greater than 20 kiloWatts/cm 2 .  
   
   
       10 . The method of  claim 1 , including delivering a flow of irrigant to the treatment area, and wherein the delivered laser radiation passes through some of the irrigant before reaching the surface of the tissue.  
   
   
       11 . The method of  claim 1 , wherein said delivering comprises using a endoscope, with an optical fiber directing laser radiation from the fiber to a treatment area on the tissue.  
   
   
       12 . The method of  claim 1 , including applying only local anesthetic during said delivering.  
   
   
       13 . The method of  claim 1 , wherein said producing includes generating said laser radiation using a solid state laser with greater than 60 Watts average output power.  
   
   
       14 . The method of  claim 1 , wherein said producing includes generating said laser radiation using a solid state laser with greater than 20 Watts average output power.  
   
   
       15 . An apparatus for photoselective vaporization of tissue, comprising: 
 a laser producing laser radiation having a wavelength in a range from about 200 nm to about 1000 nm;    an optical fiber port coupled to the laser, adapted for connection to an optical fiber used to direct laser radiation from the fiber to a treatment area on the tissue;    a secure card key interface adapted to enable said laser; and wherein the laser and optical fiber are adapted to deliver the laser radiation with an average irradiance in the treatment area sufficient for tissue removal.    
   
   
       16 . The apparatus of  claim 15 , wherein the laser comprises a solid state laser with greater than 60 Watts average output power.  
   
   
       17 . The apparatus of  claim 15 , wherein the laser comprises a solid state laser with greater than 20 Watts average output power.  
   
   
       18 . The apparatus of  claim 15 , wherein the wavelength is about 532 nm.  
   
   
       19 . The apparatus of  claim 15 , wherein oxyhemoglobin is a primary chromophore of said tissue.  
   
   
       20 . The apparatus of  claim 15 , wherein said tissue comprises prostate tissue.  
   
   
       21 . The apparatus of  claim 15 , including non-linear optics producing a second or higher harmonic output wherein the non-linear optics comprise at least one of LBO and BBO  
   
   
       22 . The apparatus of  claim 15 , wherein the average irradiance is greater than 10 kiloWatts/cm 2  and the optical fiber is adapted to cause a spot size of at least about 0.05 mm 2  in the treatment area.  
   
   
       23 . The apparatus of  claim 15 , wherein the laser comprises a Neodymium doped solid state laser medium.  
   
   
       24 . The apparatus of  claim 15 , wherein the laser and optical fiber are adapted to deliver laser radiation having an average irradiance in the treatment area greater than 20 kiloWatts/cm 2 .  
   
   
       25 . The apparatus of  claim 15 , wherein the laser and optical fiber are adapted to deliver laser radiation having an average irradiance in the treatment area greater than 30 kiloWatts/cm 2 .  
   
   
       26 . The apparatus of  claim 15 , wherein the laser and optical fiber are adapted to deliver laser radiation having a spot size is less than about 0.8 mm 2  in the treatment area.  
   
   
       27 . The apparatus of  claim 15 , wherein the optical fiber includes a side firing tip, and is further adapted for placement of said side firing tip within about  1  mm, or less, of the treatment area.  
   
   
       28 . The apparatus of  claim 15 , including an endoscope.  
   
   
       29 . The apparatus of  claim 15 , wherein the laser includes a Q-switch.