Surgical laser systems and laser lithotripsy techniques

Abstract

A laser fiber for use in performing a medical laser treatment includes an optical fiber and a fiber tip. The optical fiber includes a terminating end surface at a distal end. The fiber tip is positioned at the distal end of the optical fiber and includes a transmissive portion and a spacer portion. Laser energy discharged from the terminating end surface of the optical fiber is transmitted through the transmissive portion. The spacer portion defines a distal terminating end of the fiber tip that is spaced a predetermined distance from the terminating end surface of the optical fiber. The predetermined distance is set for shock wave generation for calculus destruction at the distal terminating end of the fiber tip.

What is claimed is: 
     
         1 . A laser fiber for performing laser lithotripsy comprising:
 an optical fiber having a distal end and a terminating end surface at the distal end; and   a fiber tip at the distal end of the optical fiber, the fiber tip including a transmissive portion, through which laser energy discharged from the terminating end surface of the optical fiber is transmitted, and a spacer portion defining a distal terminating end of the fiber tip that is spaced a predetermined distance from the terminating end surface of the optical fiber;   wherein the predetermined distance is set for shock wave generation for calculus destruction at the distal terminating end of the fiber tip.   
     
     
         2 . The laser fiber according to  claim 1 , wherein the fiber tip is attached to the distal end of the optical fiber. 
     
     
         3 . The laser fiber according to  claim 2 , wherein the fiber tip is removably attached to the distal end of the optical fiber. 
     
     
         4 . The laser fiber according to  claim 1 , wherein the optical fiber is contained within a fiber support, and the fiber tip is attached to the fiber support. 
     
     
         5 . The laser fiber according to  claim 4 , wherein the fiber tip is removably attached to the fiber support. 
     
     
         6 . The laser fiber according to  claim 1 , wherein the transmissive portion includes the spacer portion. 
     
     
         7 . The laser fiber according to  claim 1 , wherein the spacer portion extends distally from the transmissive portion. 
     
     
         8 . The laser fiber according to  claim 1 , wherein the fiber tip comprises a sleeve portion having a proximal end that surrounds the distal end of the optical fiber and supports the transmissive portion and the spacer portion. 
     
     
         9 . The laser fiber according to  claim 1 , wherein the transmissive portion comprises a lens that focuses laser energy discharged from the terminating end surface of the optical fiber. 
     
     
         10 . The laser fiber according to  claim 9 , wherein the lens is positioned at a proximal end of the transmissive portion. 
     
     
         11 . The laser fiber according to  claim 9 , wherein the lens is positioned at a distal end of the transmissive portion. 
     
     
         12 . The laser fiber according to  claim 1 , wherein the distal terminating end of the fiber tip has a convex surface. 
     
     
         13 . The laser fiber according to  claim 1 , wherein the fiber tip forms a sealed cavity around the terminating end surface of the optical fiber. 
     
     
         14 . A surgical laser system for performing laser lithotripsy comprising:
 a laser fiber comprising:
 an optical fiber having a distal end and a terminating end surface at the distal end; and 
 a fiber tip at the distal end of the optical fiber, the fiber tip including a transmissive portion, through which laser energy discharged from the terminating end surface of the optical fiber is transmitted, and a spacer portion defining a distal terminating end of the fiber tip that is spaced a predetermined distance from the terminating end surface of the optical fiber; 
 wherein the predetermined distance is set for shock wave generation for calculus destruction at the distal terminating end of the fiber tip; and 
   a laser generator configured to output laser energy that is optically coupled to a proximal end of the optical fiber, wherein the laser energy is transmitted through the optical fiber and is discharged through the terminating end surface of the optical fiber and the fiber tip.   
     
     
         15 . A method of fragmenting a calculus using a laser fiber that includes an optical fiber having a distal terminating end surface at a distal end, and a fiber tip at the distal end of the optical fiber, the fiber tip including a transmissive portion and a spacer portion that defines a distal terminating end of the fiber tip that is spaced a predetermined distance from the terminating end surface of the optical fiber, the method comprising:
 engaging the calculus with the terminating end of the fiber tip to position the terminating end surface of the optical fiber at the predetermined distance from the calculus;   transmitting laser energy through the optical fiber;   discharging the laser energy through the terminating end surface of the optical fiber;   exposing the calculus to the laser energy while the calculus is maintained at the predetermined distance from the terminating end surface using the spacer portion; and   fragmenting the calculus in response to exposing the calculus to the laser energy.   
     
     
         16 . The method according to  claim 15 , exposing the calculus to the laser energy comprises transmitting the laser energy through the transmissive portion of the fiber tip. 
     
     
         17 . The method according to  claim 16 , wherein transmitting the laser energy through the transmissive portion comprises focusing the laser energy on the calculus through a lens of the transmissive portion. 
     
     
         18 . The method according to  claim 17 , wherein the lens is located at one of a proximal end of the transmissive portion and a distal end of the transmissive portion. 
     
     
         19 . The method according to  claim 16 , wherein exposing the calculus to the laser energy comprises transmitting the laser energy through a sealed cavity around the terminating end surface formed by the fiber tip. 
     
     
         20 . The method according to  claim 15 , further comprising diffusing a shock wave at the terminating end of the fiber tip generated in response to exposing the calculus to the laser energy using a convex surface at a distal end of the fiber tip.