Medical system including a flexible waveguide mechanically coupled to an actuator

Abstract

In general, in one aspect, the disclosure features a system that includes a flexible waveguide having a hollow core extending along a waveguide axis and a region surrounding the core, the region being configured to guide radiation from the CO 2 laser along the waveguide axis from an input end to an output end of the waveguide. The system also includes a handpiece attached to the waveguide, wherein the handpiece allows an operator to control the orientation of the output end to direct the radiation to a target location of a patient and the handpiece includes a tip extending past the output end that provides a minimum standoff distance between the output end and the target location.

1 - 25 . (canceled) 
     
     
         26 . A method comprising the steps of:
 guiding radiation through an optical waveguide to tissue of a patient, the waveguide forming a hollow core; and   directing gas to the tissue while guiding the radiation,   wherein the radiation and the gas are sufficient to cut the tissue and to coagulate blood.   
     
     
         27 . The method of  claim 26 , wherein the radiation has a power of at least about 1 Watt. 
     
     
         28 . The method of  claim 26 , wherein the radiation has a wavelength of at least about 1 micron. 
     
     
         29 . The method of  claim 26 , wherein the gas has a flow rate of at least about 1 liter/minute. 
     
     
         30 . The method of  claim 26 , wherein the gas directed to the tissue has a pressure of at least 0.2 PSI. 
     
     
         31 . The method of  claim 26 , wherein a flow rate of the gas varies. 
     
     
         32 . The method of  claim 26 , further comprising ceasing the guidance of radiation and reducing a flow rate of the gas. 
     
     
         33 . The method of  claim 26 , further comprising adjusting remotely a flow rate of the gas. 
     
     
         34 . The method of  claim 26 , wherein the gas directed to the tissue has a temperature of at least about 60° C. 
     
     
         35 . The method of  claim 26 , wherein the gas directed to the tissue has a temperature of less than about 10° C. 
     
     
         36 . The method of  claim 26 , wherein the gas comprises at least one of air, nitrogen, oxygen, carbon dioxide, or a noble gas. 
     
     
         37 . The method of  claim 26 , wherein the gas comprises a gas mixture. 
     
     
         38 . The method of  claim 26 , wherein cutting comprises at least one of excising and ablating. 
     
     
         39 . The method of  claim 26 , wherein the gas is directed to the tissue through the hollow core of the optical waveguide. 
     
     
         40 . A medical laser system comprising:
 a laser;   an optical waveguide forming a hollow core coupled to the laser;   a delivery device coupled to the waveguide, the delivery device being selected from the group consisting of a handpiece, an endoscope, and a robot; and   a gas input port configured to receive gas from a gas source,   wherein during operation, radiation from the laser and the gas from the gas source are delivered to tissue of a patient, the radiation and gas being sufficient to incise the tissue and substantially coagulate blood.   
     
     
         41 . The medical laser system of  claim 40 , wherein the laser is configured to provide radiation having a wavelength of about 1 micron or more 
     
     
         42 . The medical laser system of  claim 40 , wherein the laser is selected from the group consisting of a CO 2  laser, an Nd:YAG laser, an Er:YAG laser, an Er, Cr:YSGG laser, a Ho:YAG laser, a free electron laser, and a quantum cascade laser. 
     
     
         43 . The medical laser system of  claim 40 , wherein the laser is configured to provide radiation having a power of at least about 1 Watt. 
     
     
         44 . The medical laser system of  claim 40 , wherein the gas source comprises at least one of a gas cylinder, a compressor, or a blower.