Laterally reflecting tip for laser transmitting fiber

An operating assembly for use in a liquid operating environment includes a flexible elongated light transmitting fiber having a light reflecting tip mounted thereon for reflecting the light beam laterally. The tip includes a number of features which minimize undesired heating of the tip. The tip is preferably made of solid gold and has a reflecting mirror surface coined on the gold tip. A lateral flushing passageway is disposed through the tip and allows surrounding ambient liquid to flow across the surface of the mirror to aid in cooling the tip and to aid in keeping the mirror clean. The tip is preferably mounted on the fiber by crimping. The tip includes a sufficient volume of material having a sufficient thermal conductivity located between the reflecting mirror and the crimped connection so as to dissipate heat energy which may be generated in the tip and to avoid sufficient heat energy reaching the crimped connection to cause a thermally induced failure of the mechanical attachment of the tip to the fiber at the crimp.

BACKGROUND OF THE INVENTION 
1. Field Of The Invention 
The present invention relates generally to devices for use in laterally 
reflecting light energy from a flexible elongated light transmitting 
fiber, and more particularly, but not by way of limitation, to such 
devices designed for use with laser light transmitting fibers. 
2. Description Of The Prior Art 
One developing area of medical technology involves the application of light 
energy, typically laser light energy, to a site in the patient's body to 
alter, remove or destroy tissue in the patient's body. This may be done 
with bare fibers or with fibers having an optically absorbing metal tip on 
the distal end. Such tips typically absorb all or part of the laser energy 
so that the tip itself is heated to a clinically significant extent 
whereby the tissue is at least partially treated by heat conduction from 
the heated tip which is placed in contact with the tissue. The tips also 
may have apertures for directing a portion of the laser light either 
directly or by reflection upon the tissue to be treated. 
Many medical procedures utilizing such tips are more easily accomplished if 
the laser energy is reflected laterally from the longitudinal axis of the 
fiber so that it can be directed upon tissue which would be difficult to 
treat with light emitted axially from the fiber. 
SUMMARY OF THE INVENTION 
The present invention is directed to a laterally reflecting tip which 
reflects substantially all incident laser light energy laterally outward 
through an aperture so that there is no clinically significant heating of 
the tip. The tip includes an elongated, thin, cylindrical body having a 
fiber receiving longitudinal opening for receiving the distal end portion 
of the fiber. The body has a lateral passageway defined diametrically 
therethrough and intersecting the longitudinal opening. A reflecting 
mirror surface means is defined on the body for reflecting light from the 
fiber laterally outward through the lateral passageway. The lateral 
passageway being disposed diametrically through the body provides a 
flushing means for permitting surrounding fluid to flow through the 
lateral passageway across the reflecting mirror surface to reduce 
collection of contaminants on the reflecting mirror surface and also to 
aid in cooling the tip. 
In another aspect, the reflecting tip of the present invention is designed 
so that whatever heat is generated at the reflecting mirror surface means 
will be quickly dissipated into the surrounding liquid environment before 
that heat energy can cause sufficient heating of the mechanical attachment 
between the tip and the fiber so as to cause a failure of that mechanical 
attachment. 
Both of these goals are accomplished with an operating assembly for use in 
a liquid operating environment which includes a fiber and a tip. 
The fiber is a flexible, elongated, light transmitting fiber having a 
distal end portion with a distal fiber end defined thereon. The fiber 
includes a core, a cladding surrounding said core, and an outer protective 
jacket surrounding said cladding. 
The tip is a light reflecting tip including a body and a reduced diameter, 
hollow, crimping cylinder extending proximally from the body. The body and 
the crimping cylinder are preferably integrally constructed although they 
may be separate components which are attached together. 
The body and the crimping cylinder have a body bore defined therein. The 
distal end portion of the fiber is received in the body bore. 
The tip is mechanically attached to the fiber by at least one crimp in the 
crimping cylinder. This crimp mechanically attaches the tip to the outer 
protective jacket of the fiber. Preferably, there are a plurality of such 
crimps. 
A reflecting mirror surface means is defined on the body for laterally 
reflecting light from the fiber. The body has a lateral flushing 
passageway means defined laterally through the body and intersecting the 
body bore for permitting surrounding liquid to flow through the lateral 
flushing passageway means across the reflecting mirror surface means. This 
flow through the flushing passageway aids in cooling the tip and also aids 
in keeping the reflecting mirror surface means free of debris which 
further aids in preventing overheating of the tip. It will be appreciated 
that as optically absorbing tissue debris collects on the reflecting 
mirror surface means, it will cause undesired heating of the tip which in 
turn will cause more debris to be accumulated or burned on the mirror 
surface, which rapidly escalates into an overheating situation if not 
controlled. 
Problems of thermal degradation at the mechanical attachment between the 
crimp and the outer protective jacket of the fiber are further reduced by 
designing the tip so that the body includes sufficient material of 
sufficient thermal conductivity located between the reflecting mirror 
surface means and the crimp to sufficiently dissipate to the liquid 
operating environment the heat generated at the reflecting mirror surface 
means so that the temperature at the crimp remains sufficiently low that 
there is no failure of the mechanical attachment of the tip to the outer 
protective jacket of the fiber during normal operation of the assembly. 
Numerous objects, features and advantages of the present invention will be 
readily apparent to those skilled in the art upon a reading of the 
following disclosure when taken in conjunction with the accompanying 
drawings.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
Referring now to the drawings, and particularly to FIGS. 1 and 2, a tip and 
fiber assembly is thereshown and generally designated by the numeral 10. 
The assembly 10 includes a two-piece light reflecting tip 12 mounted upon 
a distal end portion 14 of a flexible elongated light transmitting fiber 
16. 
The two-piece tip 12 includes an elongated body 18 which is best shown in 
isolation in FIGS. 3-5 and a clamping sleeve 20 which is illustrated in 
isolation in FIG. 6. 
The fiber 16 is a commercially available laser light transmitting fiber. 
Such fibers include a flexible elongated cylindrical core 22 which is 
surrounded by a cladding of lower optical refractive index material which 
is overlain with an outer protective jacket. As seen in FIG. 2, when 
assembled with the tip of the present invention, the outer cladding and 
jacket of the fiber 16 are preferably trimmed back to end at 23 with the 
fiber core 22 extending distally beyond the end 23 of the outer protective 
layers. This minimizes the possibility of burning of the outer protective 
layers due to laser energy reflected back from the mirror surface. 
The elongated body 18 has a distal head portion 24 and has first and second 
flexible legs 26 and 28 extending proximally from the head portion 24. 
Although there is no critical line of distinction between the head portion 
24 and the legs 26 and 28, the head portion 24 can generally be described 
as having a length 25 as seen in FIG. 3, and the legs 26 and 28 can 
generally be described as having a length 27. Head portion 24 has a 
squared-off flat end 21. 
As used herein the terms distal and proximal are used in relation to the 
terminology generally used for the fiber 16 with the distal end of fiber 
16 being indicated at 31 in FIG. 2, and with the proximal end of the fiber 
16 being the other end which typically would be attached to the laser 
light source 108 (see FIG. 10). Thus the distal and proximal directions or 
relative orientations are provided for the tip 12 used in association with 
the fiber 16. 
The clamping sleeve 20 can be more generally described as a clamping means 
20 operably associated with the body 18 for urging the legs 26 and 28 
radially inward to clamp the distal end portion 14 of fiber 16 
therebetween in a manner further described below. 
As best seen in FIG. 4, a blind bore 30 is drilled into the proximal end 32 
of body 18 thus defining partially cylindrical inner surfaces 34 and 36 on 
legs 26 and 28, respectively, which surfaces 34 and 36 define a body bore 
means 30 for closely receiving and clamping the distal end portion 14 of 
the fiber 16 therebetween. 
The body 18 can be described as having a plurality of legs, which in the 
preferred embodiment are two and only two legs 26 and 28. The head portion 
24 has a reflecting mirror surface means 38 defined thereon for reflecting 
light emitted from the distal end 31 of fiber 16 laterally outward. The 
body bore means 30 terminates short of the reflecting mirror surface 38. 
The legs 26 and 28 have proximal conically tapered outer surface portions 
40 and 42, respectively, which collectively define a conically tapered 
outer body surface 44 extending over a length 46. 
A distal portion 48 of legs 26 and 28 defines a generally cylindrical outer 
surface 50 having first and second annular radially outward extending 
flanges 52 and 54 each of which has a distally facing shoulder 56 and 58, 
respectively, defined thereon. 
The body 18 is preferably formed from a cylindrical stainless steel blank 
or other biocompatible material which is machined to have the appearance 
shown in FIGS. 3 and 4. The lateral passageway 88 and legs 26 and 28 are 
partially formed by milling a slot having the width 39 as seen in FIG. 3 
into the cylindrical blank. As further described below, the body 18 may 
also be formed of solid gold in which case it will be cast or machined in 
the shape shown in FIGS. 3 and 4. 
The clamping sleeve 20 which is shown in its unassembled state in FIG. 6, 
is designed to be slidably received about the legs 26 and 28. Clamping 
sleeve 20 has an axial sleeve bore 60 defined through its proximal end 62 
for closely receiving the fiber 16. Clamping sleeve 20 further includes a 
tapered conical sleeve counterbore 64 complementary to the conically 
tapered outer body surface 44 so that when the clamping sleeve 20 slides 
in a distal direction over the legs 26 and 28, engagement of the tapered 
conical sleeve counterbore 64 with the conically tapered outer body 
surface 44, causes the legs 26 and 28 to be biased radially inwardly. 
The clamping sleeve 20 further includes a thin cylindrical distal portion 
66 and a thin cylindrical proximal portion 68 which as further described 
below are used in securing the two-piece tip assembly together and onto 
the fiber 16. 
As best seen in FIG. 2, a body abutment surface 70, which is an annular 
shoulder, is defined on the head 24 of body 18. A sleeve abutment surface 
72, which is the distal end of sleeve 20, is defined on the clamping 
sleeve 20 and is arranged to abut the body abutment surface 70 to limit 
sliding motion of the clamping sleeve 20 over the legs 26 and 28. 
The tapered conical sleeve counterbore 64 and the conically tapered outer 
body surface 44 have an interference fit prior to abutment of the sleeve 
abutment surface 72 with the body abutment surface 70. Thus, with the 
fiber 16 in place as shown in FIG. 2, as the clamping sleeve 20 slides 
distally over the legs 26 and 28, the sliding interference fit between 
tapered surfaces 64 and 44 causes the legs 26 and 28 to be cammed radially 
inward thus clamping fiber 16 therebetween. 
After the sleeve abutment surface 72 engages the body abutment surface 70, 
the clamping sleeve 20 is secured to the body 18 by forming first and 
second circumferentially rolled crimps 74 and 76 in the thin cylindrical 
distal portion 66 of clamping sleeve 20 so that the crimps 74 and 76 
engage the annular shoulders 56 and 58 to prevent the clamping sleeve 20 
from sliding backwards off the legs 26 and 28. Additionally, the thin 
cylindrical proximal portion 68 of clamping sleeve 20 is further secured 
to the fiber 16 by diametrically opposed staking crimps 78 and 80 as seen 
in FIG. 1. 
Preferably, the lengths of body 18 and clamping sleeve 20 are such that the 
distance between mirror 38 and the site where legs 26 and 28 clamp the 
outer cladding of fiber 16 is sufficient to insure adequate thermal 
transfer to surrounding cooling liquid and prevent overheating of the 
clamped site. 
It will be appreciated that the construction of the legs and clamping 
sleeve could be reversed so that the sleeve protrudes from the body with 
the legs being formed on a separate piece which slides into engagement 
with the sleeve. More generally, the tip 12 can be described as a 
two-piece tip including a first piece having a plurality of longitudinally 
extending legs and a second piece including a sleeve slidably received 
about the legs. 
The abutment surfaces 70 and 72 can be more generally described as a limit 
means 70, 72 for limiting insertion of the legs 26 and 28 within the 
clamping sleeve 20 and thereby limiting a clamping force applied to the 
fiber 16 by the legs 26 and 28. 
It is noted that the body 18 shown in FIG. 4 differs in one aspect from the 
body 18 illustrated in FIG. 2, namely in regard to the construction of the 
reflecting mirror surface means 38. 
The reflecting mirror surface means 38 is preferably made of biocompatible 
99.9+ percent gold. This can be accomplished in at least two ways. In FIG. 
4, the entire body 18 is made from gold and thus all that need be done to 
complete the reflecting mirror surface means 38 is to treat the surface to 
make it as smooth and reflective as possible. 
FIG. 2, on the other hand, illustrates a construction wherein the major 
portion of the body 18 is made of a first metal other than gold, 
preferably 316 stainless steel. An underlying mirror support surface 82 is 
defined on this first material. Then gold is laid over the underlying 
support surface in such a way as to form the gold reflecting mirror 
surface means 38. One preferred manner of doing this is to sputter deposit 
an underlying gold layer 84 onto the underlying mirror support surface 82, 
and then to diffusion bond a gold sheet 86 to the underlying gold layer 
84. 
The diffusion bonded gold sheet 86 preferably is formed from rectangular 
gold wire having a thickness of at least 0.014 inches thus providing a 
gold layer thick enough to prevent the chemical action of the surrounding 
saline medium from corroding completely through the gold layer during 
typical medical treatment procedures. The gold sheet has a width 
approximately equal to the width 39 of mirror surface 38. 
Regardless of whether the solid gold body of FIG. 4 or the stainless steel 
body with overlying gold layers of FIG. 2 is used, the final treatment of 
the gold reflecting mirror surface means 38 is preferably formed by 
coining the surface. Coining is a mechanical process whereby a very hard, 
smooth member is pressed against the surface 38 to stamp it or coin it so 
that it too carries a smooth highly reflective impression. 
As is further described below, the smooth, coined, gold reflecting mirror 
surface means 38 provides a means for reflecting substantially all of the 
light energy incident thereon from the fiber 16. 
Alternatively, the mirror surface 38 could be made smooth by electro or 
mechanical polishing or by chemical etching. 
In designing a tip for maximum reflection so that substantially all laser 
light energy incident upon the reflecting surface 38 is reflected, it is 
necessary to choose the reflecting material dependent upon the particular 
laser being utilized. Different reflective materials have more efficient 
reflective characteristics for different wavelengths of laser light. For 
example, when utilizing an Nd:YAG laser having a characteristic wavelength 
of 1064 or 1318 nanometers; a Ho:YAG laser having a characteristic 
wavelength of 2100 nanometers; a semiconducting diode laser operating at 
805 nanometers; a dye laser operating in the 630-800 nanometer range; an 
Alexandrite laser having a 680-800 nanometer tuning range; or a Sapphire 
laser having a 680-800 nanometer tuning range, the reflective surface 38 
is preferably made of gold. 
On the other hand, for a frequency doubled Nd:YAG laser having 
characteristic wavelengths of 532 or 659 nanometers, a platinum surface 38 
is preferred. Similarly, the platinum surface is preferred for an Argon 
Ion laser emitting radiation with wavelengths in the 428-528 nanometer 
range, and for a dye laser having a 400-630 nanometer tuning range. 
Gold and platinum are chosen as preferred mirror surfaces on the basis of 
their high optical reflectivities and their relative stabilities in a warm 
aqueous saline solution environment. 
As is best seen in FIG. 2, the body 18 has a lateral passageway 88 defined 
diametrically therethrough which intersects the body bore means 30. The 
lateral passageway 88 has diametrically opposite first and second end 
openings 90 and 92, respectively. The lateral passageway 88 extends across 
and runs parallel to the reflecting mirror surface means 38, and thus due 
to the slope of the reflecting mirror surface means 38, the second end 
opening 92 is substantially smaller than the first end opening 90 of 
lateral passageway 88. 
The reflecting mirror surface means 38 is set at an angle 94 to the 
longitudinal axis 96 of the fiber 16 and tip 12. Thus light exiting the 
distal end 31 of fiber core 22 falls axially (with a small divergence) 
onto the reflecting mirror surface means 38 and then is reflected 
laterally out the larger first end opening 90 of lateral passageway 88. 
There is some angular diffusion of the light which reflects from the 
reflecting mirror surface means 38 so that it tends to diffuse into a 
conical beam, and the body 38 has a conical cavity 98 superimposed upon 
the larger first end opening 90 of lateral passageway 88 thus permitting 
the reflected beam to pass laterally outward without impinging upon any 
other portions of the tip 12 other than the reflecting mirror surface 
means 38. 
The tip 12 is constructed for usage in any number of medical procedures 
wherein the tip is used to direct laser light onto human tissue to treat 
the same. The tip 12 is typically immersed in an aqueous saline solution 
during operation, but it will be appreciated that often the solution is 
contaminated with proteins from the surrounding body tissue. If these 
proteins are allowed to build up on the reflecting mirror surface means 
38, it of course will significantly degrade the operation of the tip 12. 
The lateral passageway 88 extending completely laterally through the body 
18 over the reflecting mirror surface means 38 provides a flushing means 
88 for permitting surrounding fluid, typically saline solution, to flow in 
one of the first and second end openings 90 and 92, then across the 
reflecting mirror surface means 38, then out the other of the first and 
second end openings, thus tending to cleanse the reflecting mirror surface 
means 38 and to reduce collection of contaminants on the reflecting mirror 
surface means 38. 
The flushing of saline solution through the lateral passageway 88 also aids 
in carrying away saline solution heated by laser light passing 
therethrough to prevent any significant heat buildup adjacent the tip 12. 
As further shown below, the tip 12 is designed for substantially complete 
reflection of the laser light energy incident upon mirror 38. There is no 
clinically significant heating of tip 12. 
FIGS. 7-9 are somewhat simplified versions of FIG. 2 and they illustrate 
various modifications that can be made to the reflecting mirror surface 
means 38. 
FIG. 7 illustrates the flat planar reflecting mirror surface means 38 
previously described with regard to FIGS. 2 and 4. In a preferred 
embodiment the angle 94 of surface 38 is 371/2.degree., and the distal end 
31 of fiber core 22 is cut square, i.e., it defines a plane normal to the 
axis 96 of the fiber. With such an arrangement, and with a highly 
reflective coined gold reflecting mirror surface means 38, the reflected 
beam 100, the outer extremities of which are shown in phantom lines will 
diverge slightly from a cylindrical beam due to divergence upon exiting 
fiber core 22 and due to imperfect reflection of the mirrored surface 38 
so as to form a reflected light spot 102. In a preferred embodiment the 
flat coined gold reflecting mirror surface means 38 of FIG. 7 is a means 
for providing a generally circular reflected light spot size 102 no 
greater than 3 mm diameter at a distance of 1.05 cm along the central ray 
of the deflected beam from the central axis 96 of the fiber 16. 
It is noted that with the specified angle 94, the reflected beam will 
reflect somewhat in a proximal direction. This back reflection is a 
significant aid in directing the reflected beam to hard-to-reach portions 
of cavities within the human body. The angle of reflection of the beam can 
of course be modified as desired by modifying the angle 94 and the 
configuration of the reflecting surface 38. Also, the distal end 31 of the 
fiber core 22 can be cut at an angle which will also affect the dispersion 
and direction of the light beam emitted therefrom. 
As best seen in FIG. 2, there is an axial clearance between the distal end 
31 of fiber core 32 and the reflecting mirror surface means 38. This 
permits the lowermost reflected beam to exit through the lateral 
passageway 88 without impinging upon the fiber end 31 or any portion of 
the tip 12 other than the mirror 38. 
Depending upon the type of treatment being conducted, it may be desirable 
for the reflected light spot 102 to be either more diffused or more 
concentrated. This can be accomplished by modifying the reflecting mirror 
surface means 38 as shown in FIGS. 8 or 9 to concentrate or disperse the 
beam, respectively. 
In FIG. 8, the reflecting mirror surface means 38 has a concave portion 104 
which is impinged by the beam from fiber core 22 thus concentrating the 
reflected beam 100A to form a smaller reflected beam spot 102A as compared 
to FIG. 7. 
In FIG. 9, the reflecting mirror surface means 38 includes a convex portion 
106 which causes the reflected beam 100B to be more dispersed and thus 
form a larger reflected beam spot 102B as compared to the apparatus of 
FIG. 7. 
It will be appreciated that FIGS. 7-9 are only schematically illustrated 
and are not necessarily geometrically correct. The angles of the beams 
have been somewhat exaggerated to illustrate the difference between the 
various embodiments. 
FIG. 10 schematically illustrates the various apparatus with which the 
fiber 16 and tip 12 are typically used. The proximal end of the fiber 16 
is connected to a laser 108 which produces the laser light which is 
transmitted through the fiber 16 and then reflected by tip 12. In the 
present disclosure the word light is used in its broad sense, meaning 
electromagnetic radiation which propagates through space and includes not 
only visible light, but also infrared, ultraviolet and microwave 
radiation. In the preferred embodiment, the light transmitted by fiber 16 
is laser light produced by the laser 108. 
The fiber 16 is typically utilized with a conventional endoscope 116, which 
may be rigid or flexible, and which carries the fiber 16 in a cylindrical 
passage 118 defined in an endoscopic tube 120. The endoscopic tube 120 may 
include a parallel optical viewing fiber (not shown) and parallel fluid 
flow conduits (not shown). Also, the cylindrical passage 118 may itself be 
utilized as a fluid flow passage to allow irrigating fluids to flow to the 
tip 12. 
It will be appreciated that depending upon the medical procedure being 
performed, the endoscopic tube typically may need to pass through various 
curved cavities in the human body so as to reach the area to be treated. 
In such case a flexible endoscope will be used. 
The tip 12 and fiber 16 which are assembled according to the present 
invention preferably are constructed so that they can pass through the 
cylindrical passage 118 of endoscopic tube 120 when the endoscopic tube 
120 is contorted in the necessary fashion. Thus, the fiber 16 assembled 
with tip 12 must be capable of curving to pass through the curved 
cylindrical passage 118. Also, the fiber 16 and tip 12 must pass through 
the endoscope 116 itself. Typically the most severe curvature through 
which the fiber 16 and tip 12 must pass is the bend at connection 117 
where the fiber 16 enters the endoscope 116 from a laterally offset 
position and then must pass into the tube 120. The radius of curvature of 
this bend on existing endoscopes is approximately 10 cm. This passage may 
have a diameter on existing endoscopes as small as 2.5 mm. 
FIG. 11 is a schematic, segmented, cross-section portion of the endoscopic 
tube 120 in the curved area designated in FIG. 10. The fiber 16 and tip 12 
are shown in phantom lines in FIG. 11 as they would appear when the tip 12 
and fiber 16 are being run in a distal direction through the passage 118 
so that they ultimately will extend from the distal end of endoscopic tube 
120 as illustrated in FIG. 10. 
A typical passage 118 of available endoscopic tubes 120 has a diameter of 
no greater than 2.5 mm. The preferred optical fiber described below has a 
design minimum bending radius of 1 cm which can easily conform to passage 
118 so long as the tip 112 can fit through the curved passage. Since the 
most severe bend to be encountered is that at junction 117, the fiber 16 
and tip 12 should be so constructed and dimensioned as to provide an 
assembly capable of passing through a curved cylindrical passage having a 
diameter of 2.5 mm and a radius of curvature of 10 cm. 
Prior art tip constructions for laterally reflecting tips have been 
relatively bulky and have been incapable of passing through such a narrow 
curved passage. The present invention has solved this problem. In a 
preferred embodiment this is accomplished by constructing the tip 12 to 
have a length 122 (see FIG. 1) of 0.3543 inches (9,000 mm) and an outside 
diameter 124 of 0.0866 inches (2,200 mm). This tip is generally 
cylindrical in shape and is concentrically mounted upon the distal end 
portion 14 of fiber 16. Preferably the tip 12 has a maximum diameter 124 
of no greater than 2.2 mm, and a length no greater than 1 cm. 
The preferred light transmitting fiber 16 for use with the tip 12 having 
the dimensions just described is a conventional fused silica fiber. This 
fiber has a minimum bending radius of 1 cm. The silica core has a diameter 
of 600 microns and the fiber with cladding has an outside diameter of 
0.040 inch which is clamped within the bore 30 of tip 12 which has a bore 
diameter of 0.040 inches. 
In this preferred embodiment the tapered outer surface 44 and tapered inner 
counterbore 64 have an angle of taper such as indicated at 126 in FIG. 3 
in the range of from 4.2.degree. to 4.8.degree.. 
EFFICIENCY OF REFLECTION 
Measurements of reflective optical power and intensity distribution over 
the reflected beam were made on a group of nine fibers having tips 12 with 
99.9% gold reflective surface formed as described above with regard to 
FIG. 2. Similar measurements were also made on a corresponding group of 
bare fibers of identical manufacture. 
Specifically, measurements were made to assess and compare the 
reproducibility of values of reflected and emitted power and radiated 
intensity distribution within each group of optical fibers and to compare 
the efficiency of the reflection by the actual gold surface relative to 
the theoretically predicted value for an ideal gold surface. 
Measurements to determine emitted and reflected radiation power were made 
using the set-up shown in FIGS. 12A and 12B. In the tip measurements the 
central ray of the reflected beam was deviated 112 degrees from the parent 
fiber axis, and impacted the circular detector surface at its center. The 
central ray of the emerging beam was aligned in similar fashion relative 
to the detector for measurements on bare fibers. 
Measurements to determine the uniformity of reflected power from tipped 
fibers and of emitted power from the bare fibers respectively, were made 
at constant input using the Nd:YAG laser power settings of 5, 10 and 20 
watts. The distance from either reflecting or emitting surface was kept at 
7 centimeters. This was done to keep the fixed geometry for measurement at 
all power levels selected without bleaching or burning the blackened 
detector surface. 
Experiments were also performed on three fibers randomly picked from the 
tipped fiber population in order to assess the efficiency or percentage of 
power reflected in comparison to the average emitted power of the bare 
fiber population. These measurements were made at 10 watts input Nd:YAG 
laser power delivered to each fiber and with the fiber end located 1 
centimeter from the detector surface so as to collect sensibly all the 
reflected beam pattern. Collection of the entire beam with this geometry 
was established from the accompanying measurements (described below) of 
radiation intensity over the reflected beam. 
Measurements of the uniformity of distribution of radiation intensity over 
the cross section of the reflected and emitted beam profiles were made on 
tipped and bare fibers (two in each population) using the set-up of FIGS. 
13A and 13B. Light from a 5-milliwatt helium neon laser (632.8 nanometers) 
was used. 
A Coherent Radiation, Inc. Model 210 laser power meter and detector (25 mm 
aperture) was used for all measurements of the Nd:YAG laser beam power 
emitted from either the bare or the tipped fibers. A United Detector 
Technologies silicon diode based 81 optometer detector was used to measure 
the angular distribution of the emitted helium neon beam (632.8 
nanometers) for each fiber type. 
Measurements of laser power emitted by groups of nine each bare and tipped 
fibers were made under identical conditions of 5, 10 and 20 watts input 
Nd:YAG laser power. A seven centimeter distance between fiber end or tip 
and detector was maintained for all measurements. Values of average power 
and standard deviation for both bare and tipped fibers for the three 
different input Nd:YAG laser powers are found in the following Table 1. 
TABLE 1 
______________________________________ 
Measured Nd:YAG Laser Power Values From Bare 
and Tipped Fibers 
Laser Power 
Settings Bare Fiber Tipped Fiber Distance 
(w) (w) (w) (cm) 
______________________________________ 
5 4.62 .+-. 0.29.sup.a,b 
3.36 .+-. 0.15.sup.b 
7 
10 9.62 .+-. 0.34.sup.b 
7.06 .+-. 0.48.sup.b 
7 
20 18.17 .+-. 0.68.sup.b 
13.29 .+-. 0.82.sup.b 
7 
10 9.72 .+-. 0.32.sup.c 
8.81 .+-. 0.21.sup.c 
1 
______________________________________ 
.sup.a Numbers are average .+-. standard deviation 
.sup.b n = 9 
.sup.c n = 3 
As seen in Table 1 the bare fibers on the average emitted 92, 96 and 91 
percent of the input laser power at 5, 10 and 20 watts. This clustering 
suggests reproducible light transmission by the parent fiber family. 
Results for the nine tipped fibers in Table 1 show the strong uniformity of 
the percentage of reflected laser power. At laser input power values at 5, 
10 and 20 watts, respectively, detected power values from the tipped 
fibers were nominally 73 percent (see Table 1) of the average power 
emitted from the bare tip of the parent fiber at each value of input laser 
power. This large difference arises from the reflected beam diameter 
exceeding the detector aperture diameter at the 7 cm. detector to tip 
distance: thus only a fraction of the total reflected power was measured. 
In a subsequent experiment, the distance between the detector surface and 
the tip 12 was decreased to one centimeter. The detected average value of 
power emitted at 10 watts of laser input from three tipped fibers was 8.8 
plus or minus 0.21 watts. Light distribution analysis described below 
ensured that at this one centimeter detector to reflecting tip surface 
distance that essentially 100 percent of the reflected light was collected 
by the detector. Relative to the average emitted power of the bare fiber 
family (9.72 plus or minus 0.32 watts) at 10 watts input the tipped fiber 
emits approximately 92 plus percent of the power emitted by the bare tip 
onto the gold reflecting surface. Allowing for about 98 percent 
theoretical reflectivity of the pure gold surface and the possibility of 
two or more multiple reflections from the roughness of a real production 
gold surface and the non-zero standard deviations associated with the 
experimentally determined average values of power emitted by both bare and 
tipped fibers, actual differences between bare fiber and reflected power 
values can be considered to be negligibly small and the bare fiber and 
tipped fibers can be considered to emit essentially equal power values at 
equal Nd:YAG laser input values. 
Light distributions from He-Ne neon laser light (632.8 nm.) were determined 
for representative bare fiber and tipped fibers (two types each). The 
average distributions are shown in FIG. 14. Examination of these figures 
shows a spread of the beam from the bare fiber upon reflection in the tip 
12. This undoubtedly arises from a small diffuse scattering component due 
to surface irregularities on the real gold surface. This scattering 
spreads the beam from the tip 12 in essentially symmetrical fashion about 
the central ray. The significant effect of reflection of the beam from the 
fiber end 31 is one of widening without introduction of relatively more or 
less intense regions of light that is hot or cold spots within the 
bell-shaped light pattern emitted by the bare tip fiber. Therefore, the 
shape of the bare fiber beam and that of the reflected side directed beam 
from tip 12 are essentially equivalent. 
Integration of the light flux emitted by both fiber tips over the detector 
aperture gives the total power incident upon the detector. The flux 
integral P is given by: 
##EQU1## 
where P.sub.0 is the total light power emitted by the tips, F (.theta.) is 
the angular variation in the light intensity, and r is the radial distance 
on the surface of the detector of aperture radius r.sub.0. The geometry is 
shown in FIGS. 12A and 12B. Percentage values of the integral for various 
detector apertures are shown in FIG. 15 for both bare and tipped fibers. 
Performance of the integration for the tipped fiber placed 7 and 1 
centimeters, respectively, away from the detector surface gives P=0.717 
and 1.0.times.the emitted power, respectively. These values are consistent 
with average values measured at distances of 7 and 1 cm. of, respectively, 
0.73 and 0.91.times.the average power emitted by the bare fiber upon the 
reflecting surface 38 of tip 12. Since light back scattering decreases as 
wavelength increases relative to scatterer sizes going about as one 
divided by wavelength raised to the nth power (n typically between 1 and 
4), the width of the light distribution at the 1.06 micron Nd:YAG 
wavelength reflected from the tip 12 is expected to be slightly smaller 
than the measured distribution at 632.8 nanometers. 
Values of the fraction of total laser power contained within the beam as 
angle increases (radial distance increases) are plotted in FIG. 15 for 
both the bare and tipped fibers. Use of these plots shows that (1 minus 
exp(-2)) of the total power within the beam from the bare fiber end and 
the tip 12 is contained within 5 and 16 degrees, respectively, of the 
central ray of the light distribution. As the result of the wider nature 
of beam from tip 12 equal spot sizes of radius R. tissue are achieved with 
the respective bare and tipped fibers held at different distances D. from 
the tissue surface. For various spot sizes R. in the range of 1 to 4 
millimeters, the associated values of the distance to tissue are tabulated 
in the following Table 2. 
TABLE 2 
______________________________________ 
Spot Size and Distance Values for Bare and Tipped Fibers 
R.sub.0 .theta..sub.0 
D 
(mm) (deg) (cm) Fiber Type 
______________________________________ 
1 5 1.14 Bare 
1 16 0.35 Tipped 
2 5 2.28 Bare 
2 16 0.70 Tipped 
4 5 4.56 Bare 
4 16 1.40 Tipped 
______________________________________ 
Tan .theta..sub.0 = R.sub.0 /D.sub.0 
The results of optical property assessments on the tip 12 and the bare 
fibers allow the following essential equivalences to be identified: 
(1) Output beams of both tips are centrosymmetric with respect to the 
central ray of peak intensity with uniform gradual fall off in intensity 
with radius in all directions. Essentially no random hot or cold spots are 
present. 
(2) The tip 12 reflects essentially all (92.+-.4%) incident laser beam 
energy. Power densities at tissue equal to that of equivalent bare fiber 
can be achieved with the use of tip 12 by adjusting the tip to tissue 
distance, thus adjusting spot size. 
(3) The essential action of the tip 12 is to reflect the laser beam 
laterally. 
The substantially complete reflectivity of the gold mirror surface 38 also 
means that there is no clinically significant heating of the tip 12 
itself, i.e., the tip 12 does not become sufficiently hot to significantly 
affect the tissue being treated if the tip 12 is placed in contact with 
the tissue but is oriented so that the reflected light beam does not fall 
upon the tissue contacted by the tip. This is shown by the following 
example. 
EXAMPLE NO. 1 
The depths of coagulation achieved by using the tip 12 as a contact heating 
probe (no direct irradiation) and by directly irradiating tissue (no 
direct contact) were compared using 60 W of Nd:YAG laser power. Bovine 
liver (in vitro) was used as the test tissue. The arrangement for each 
experiment with the tip 12 is shown in FIGS. 16 and 17. The distance of 
tip 12 from the tissue is 4 mm in FIG. 16 which gives a spot size 
approximately equal to the 2.2 mm diameter contact size in FIG. 17. In 
FIG. 6 the tip 12 is immersed in water 206 in a beaker 204. The test 
tissue 200 is placed against one side of the beaker. 
After exposure for one minute with 60 W laser input power, surface 
bleaching of the liver color was noted at both the contact and irradiated 
sites. In FIG. 16 the bleached spot is indicated at 202. Perpendicular 
sections cut with a scalpel through each bleached spot disclosed 
coagulation bleaching to extend to depth of approximately 700 micron (0.7 
mm) and 7 mm at the contacted and irradiated sites, respectively. Thus, 
direct exposure to the laser beam as opposed to only heating the tip (in 
contact only with tissue) with the beam resulted in a 10-fold deeper 
coagulation depth and a 10-fold greater coagulation efficiency at equal 
exposure times. 
The Embodiment of FIGS. 18 and 19 
FIGS. 18 and 19 illustrate an alternative embodiment of an operating 
assembly generally designated by the numeral 300. The assembly 300 
includes the flexible elongated light transmitting fiber 16 having the 
distal end portion 22 with the distal fiber end 31 defined thereon. As 
previously described above, the fiber 16 includes a quartz core, a 
cladding 302 surrounding the core, and an outer protective jacket 304 
surrounding the cladding. The outer protective jacket 304 has been 
stripped back from the distal end portion 22 so that the cladding 302 is 
exposed. The outer protective jacket which is designated by the numeral 
304 is also seen in FIGS. 18 and 19. The cladding 302 is an optical mirror 
formed of a silica ceramic polymer. The outer protective jacket is 
typically formed of Teflon.RTM. brand polytetrafluroethane. 
The operating assembly 300 includes the fiber 16 and a light reflecting tip 
generally designated by the numeral 306. The tip 306 includes a body 308 
and a reduced diameter hollow crimping cylinder 310 extending proximally 
from the body 308. In the embodiment of FIGS. 18 and 19, the body 308 and 
crimping cylinder 310 are integrally constructed from a single piece of 
material. Preferably, the body 308 and crimping cylinder 310 are machined 
from a piece of 24-carat gold material having in excess of 99.9% purity. 
As seen in FIG. 19, the body 308 and crimping cylinder 310 have a body bore 
312 defined therein having a main bore portion 314 and a counterbore 
portion 316. The distal end portion 22 of the fiber 16 is received in the 
body bore 312. The junction between the main bore portion 314 and 
counterbore 316 defines a ledge 318 which abuts a distal end of the outer 
protective jacket 304. This aids in positioning the distal end 31 of fiber 
16 at the appropriate distance from the reflecting mirror surface means 
318 which is formed on a distal head portion 320 of the body 308. The 
reflecting mirror surface 318 is preferably formed by coining. 
The tip 306 is attached to the fiber 16 by a plurality of crimps 322 formed 
in the crimping cylinder 310 to crimp the cylinder 310 tightly against the 
outer protective jacket 304 of fiber 16 so as to mechanically attach the 
tip 306 to the fiber 16. The tip 306 is attached to the fiber 16 solely by 
the plurality of crimps 322. Tip 306 is free from attachment to any 
structure other than fiber 16. 
The body 308 has an oval-shaped concavity 323 defined therein which 
intersects the body bore 312. The concavity 323 includes a flat surface 
324 which has the reflecting mirror surface means 318 formed therein. A 
radial bore 326 is defined in the other side of body 308 and intersects 
the concavity 323. Concavity 323 and radial port 326 collectively define a 
lateral flushing passageway 328 intersecting the body bore 312. The 
lateral flushing passageway 328 permits surrounding liquid to flow 
therethrough across the reflecting mirror surface means 318 thereby aiding 
.in cooling the tip 306. The lateral flushing passageway 328 has liquid 
from the surrounding liquid environment flowing in one end thereof, 
typically in through the radial port 328 and out the other end thereof, 
typically through the open side of concavity 323. The laser energy passing 
through the liquid in the space between the distal end 31 of fiber 16 and 
the reflecting mirror surface 318 tends to cause boiling of that liquid. 
Gaseous bubbles from this boiling move away from the tip out through the 
open end of concavity 323 thus tending to draw surrounding ambient liquid 
into the radial port 326 by a Venturi effect. The transverse flushing 
passageway supplies to mirror and fiber tip a vigorously flowing fluid 
stream drawn from the surrounding fluid within the patient's body cavity 
through the flushing passageway by the Venturi effect. This effect is 
initiated by the escaping flow of fluid heated both by absorption of the 
laser beam and by conduction from the laser heated mirror surface. Laser 
power is typically high with the present invention, up to 80 watts. Thus, 
the flow rate is large and turbulent. This is evidenced by visualization 
of rapidly swirling water region of different heat dependent optical 
refractive index as seen in nearly boiling water heated in a pan. The 
effect is to cool and flush the metal mirror surface and body. 
The lateral flushing passageway 328 is free from communication with any 
source of flushing fluid other than this surrounding liquid from the 
surrounding liquid environment; this is contrasted to certain prior art 
designs wherein flushing fluid is force fed through the tip bore 312 and 
out through a lateral opening in the tip. 
The primary mode of failure encountered by metal tipped laser fibers tends 
to be the failure of the mechanical attachment of the tip to the fiber. 
This typically will occur when excessive heating of the tip occurs thus 
causing thermal degradation of the outer protective jacket 304 to which 
the tip is attached. We have discovered that in normal operating 
conditions, such failures can be avoided through a combination of several 
design features, all of which contribute to reducing this undesired 
heating of the tip. The first such feature is the use of a highly 
reflective coined gold mirror surface 318 which reflects substantially all 
of the light incident thereon. This is contrasted to many prior art 
designs which intentionally absorb a significant amount of laser energy so 
as to provide a clinically significant heating of the tip so that tissue 
can be affected by contacting the tip to the tissue. As previously noted, 
the present invention is specifically designed to reflect substantially 
all light incident on the mirror so that there is no clinically 
significant heating of the tip. 
A second feature of the present invention which contributes to avoiding 
undesired heating of the tip is the provision of the lateral flushing 
passageway 328 which allows surrounding ambient liquid to flow 
therethrough across the reflecting mirror surface 318. This contributes to 
avoiding heating of the tip in at least two ways. First, the flow of 
liquid through the flushing passageway 328 tends to carry away from the 
tip heated liquid adjacent thereto which is heated both by the laser 
energy passing through the liquid and by conduction from the mirror. 
Second, the flushing liquid flowing through the flushing passageway 328 
tends to prevent organic debris from accumulating on the mirror surface 
318. 
It will be appreciated that it is particularly important to keep the 
reflecting mirror surface 318 as clean as possible. The surrounding liquid 
tends to have a significant amount of organic material therein, and to 
some extent over a period of time this material will cook onto the 
reflecting mirror surface 318 thus somewhat darkening it and reducing its 
reflectivity. That in turn will cause greater heating of the reflecting 
mirror surface 318 which in turn will cause additional organic material to 
cook onto the mirror. It will be appreciated that this condition feeds on 
itself and will rapidly progress to a tip failure if the mirror surface 
318 is not kept clean. 
A third feature which is particularly emphasized by the embodiment of FIGS. 
18 and 19 can also significantly contribute to eliminating failure of the 
mechanical connection between the tip 306 and the fiber 16. The heating of 
the tip adjacent the mirror 318 and in the distally outer portions of the 
head 320 of tip 306 is not per sea problem. The problem only occurs when 
the proximal portions of the tip adjacent crimps 322 become sufficiently 
hot that thermal degradation of the outer protective jacket 304 of fiber 
16 will occur. Thus, we have discovered that such mechanical failure can 
be greatly reduced by including in the tip 306 an intermediate portion 330 
located between the reflecting mirror surface 318 and the crimps 322. This 
intermediate portion 330 must include sufficient material of sufficient 
thermal conductivity so as to dissipate to the surrounding liquid 
operating environment enough of the heat generated at the reflecting 
mirror surface means 318 so that the temperature at the crimps 322 remains 
sufficiently low that there is no failure of the mechanical attachment of 
the tip 306 to the outer protective jacket 304 of the fiber 16 during 
normal operation of the assembly 300. This construction of the 
intermediate portion 330 is dependent both upon the physical nature of the 
material and the amount of the material which is there present. 
Preferably, the entire tip 306 is constructed of 24-carat gold which has a 
very high thermal conductivity which will transfer heat energy to the 
surrounding liquid operating environment at a much more rapid rate than 
will many other materials from which tips have been built in the past, 
such as stainless steel. The amount of material in intermediate portion 
330 is determined in part by the length of the portion 330 which has been 
chosen so as to provide the necessary outer surface area for radiating the 
heat which can be generated at mirror surface 318. 
It is noted that the necessary size of the intermediate portion 330 is 
dependent upon the power density which is being applied to the tip. At 
lower power levels, heating of the tip is a less serious problem. 
The increased length of the intermediate portion 330 of tip 306 as 
contrasted to prior designs provides several advantages. First, the longer 
distance provides better isolation of the heat source 318 from the crimps 
322. Second, the additional length also gives more surface area for 
dissipation of heat to the surrounding liquid. Finally, the increased 
length of the tip provides room for additional crimps 322 to increase the 
strength of the overall mechanical connection. 
In general, these several features which contribute to controlling heating 
of the tip 306 can be described as follows. The body 308, the crimping 
cylinder 310, the reflecting mirror surface means 318 and the lateral 
flushing passageway 328 are arranged and constructed so as to provide a 
means for preventing thermal degradation of the outer protective jacket 
304 at the crimps 322 and for thereby preventing failure of the mechanical 
attachment between the crimping cylinder 310 and the outer protective 
jacket 304. 
It is noted that in the preferred embodiment of FIGS. 18 and 19, the 
crimping cylinder 310 is formed of 24-carat gold. Although certain prior 
art tips have utilized gold plating for their reflecting mirror surface, 
the tip of FIGS. 18 and 19 is the first to construct the entire tip of 
gold and particularly is the first to construct those portions of the tip 
which are mechanically attached to the fiber from gold. Traditional 
thinking has been that gold does not have sufficient mechanical strength 
to be utilized for the mechanical attachment of the tip to the fiber. 
Thus, typically prior designs have utilized stainless steel materials at 
the point of attachment. We have discovered, however, that the failure of 
a typical tip mounting to a fiber is due to the thermal degradation of the 
underlying outer protective jacket of fiber 16 and not to the mechanical 
strength of the tip itself. Physical examination of failed specimens has 
shown that the failure is a thermal decomposition of the 
polytetrafluoroethane material. The carbonaceous material in that outer 
protective coating 304 will soften, chemically degrade, char and become 
black from thermal decomposition. These events can initiate at a 
temperature of approximately 150.degree. C. 
Accordingly, we have discovered that the benefits of using gold for the 
crimping cylinder 310, namely the increased heat transfer and thus reduced 
heating of the gold, are much more important than the lesser mechanical 
strength of the gold. We have discovered that sufficient crimps 322 can be 
provided to provide sufficient mechanical attachment strength between the 
gold and the fiber thus providing a means of attachment which is much less 
susceptible to thermal failure than is a similar stainless steel 
structure. 
The thermal conductivity of gold is 295 W. per meter degree K. This is 
contrasted to stainless steel which typically has a thermal conductivity 
of about 25.1 W. per meter degree K. Thus, the thermal conductivity of 
gold is approximately ten times greater than stainless steel and thus heat 
is transferred to the surrounding liquid environment approximately ten 
times faster by a gold tip than by a stainless steel tip. In general, the 
preferred materials for the tip 306 should have a thermal conductance of 
150 W per meter degree K or greater. If a stainless steel body were used, 
then to obtain the same degree of thermal isolation of the crimp from the 
mirror, it would be necessary to increase the length of the body by a 
factor of about ten (295/25.1). 
Another advantage of the use of solid gold for forming the tip rather than 
the use of gold plate on a tip made of a second material such as stainless 
steel is that many tips using gold plating have encountered failure of the 
gold plating at some stage during the operating procedure. With a solid 
gold tip, there is no danger that a plated gold mirror surface will 
deteriorate exposing non-gold material therebelow to corrosion, lessened 
reflection, and increased heating. 
Another reason that gold is the preferred material for these tips is that 
the tip is being used in a corrosive environment of saline solution. 
Although other materials such as copper for example can provide good 
reflectance, those materials are not stable in a corrosive environment. 
Other materials could be utilized depending upon the context in which the 
tip is used. If the tip is not being used in a corrosive environment, 
copper provides a good material since it, too, has a high thermal 
conductivity. Another material with an excellent thermal conductivity is 
diamond. 
Lower purity golds such as 12-carat or 18-carat golds are not as desirable. 
These golds are formed by alloying of the gold material with copper or 
nickel. Although this alloying increases the hardness and mechanical 
strength of the material, it decreases the reflectivity of the material. 
This is undesirable since maximum reflectivity is necessary in order to 
minimize the heat generated at mirror 318 in the first place. 
We have determined that forming of the mirror 318 by coining of a solid 
gold surface is preferable to the use of a plated gold surface for several 
reasons. First, the coining operation removes the surface roughness. 
Second, the coining operation improves the optical characteristics and 
chemical resistance of the gold surface. The coining operation increases 
the density of the subsurface layer of gold thus providing less surface 
area for chemical reaction. Also, the thin cold worked layer at the coined 
surface is more mechanically akin to the underlying bulk gold than is a 
plated gold layer and thus it is much less likely to delaminate or flake 
off. 
EXAMPLE NO. 2 
A number of tips constructed in accordance with FIGS. 18 and 19 were 
immersed in quiescent normal saline solution confined within an 8 mm. 
diameter channel bored through an Irish potato and lased with 1,064-.mu.m 
Nd:YAG radiation at 60 or 90 W. The emerging beam intercepted by the 
potato tissue resulted in heating and coagulation of the tissue. Tips were 
powered continuously for fifteen minutes with a rotation of the tip of 
90.degree. every sixty seconds. Following the continuous lasing, the tips 
were inspected visually at 10.times. magnification and the optical 
reflectance at 1,064 mm compared with the value measured prior to lasing. 
Reflectance measurements using 1,064-nm Nd:YAG laser radiation showed 
virtually negligible decreases from 92.6 to 89.6% and 93.2 to 87.8% upon 
fifteen minute lasing in quiescent saline solution at 60 and 80 W, 
respectively. During the latter eight to ten minutes lasing, the solution 
was observed to boil and to incorporate a sludgy residue of potato from 
the walls of the 8 mm bore. Visual examination of the gold mirror surface 
of the tips showed a thin hazy coating outside an approximately 1 mm 
diameter clear region centered upon the beam impact area on the reflecting 
mirror. Soaking the tip for approximately twenty minutes in 1 N nitric 
acid resulted in removal of the hazy coating, thus suggesting its organic 
nature deriving from the potato. 
Rigorous mechanical flexure of the gold tips relative to each of these 
fibers disclosed no loosening. Lack of heat sinking of thermal energy from 
the tip to the surrounding fluid could be expected to have led to 
thermally induced degradation of the buffer polymer of the outer 
protective jacket 304 and loss of the competency of the mechanical 
connection between the tip 306 and the outer protective jacket 304. No 
evidence of thermally induced weakening of this mechanical connection or 
misalignment of the tip 306 and fiber 16 were discerned after the extended 
lasing in boiling solution. 
The results of these tests can be summarized by saying that the tip 306, 
and particularly the intermediate portion 330 thereof, includes sufficient 
material of sufficient thermal conductivity to prevent failure of the 
mechanical attachment at crimps 322 due to thermal decomposition of the 
outer protective jacket 304 when the tip 306 is continuously lased at 80 W 
input power in a saline solution for a period of at least fifteen minutes. 
Typical dimensions for a tip like that of FIGS. 18 and 19 designed for use 
with a 600 .mu.m fiber having a 600 .mu.m silica core, hard clad coat, and 
a 1,000 .mu.m diameter buffer are represented in FIG. 19. The diameter of 
the body 308 is indicated by 332 and is preferably 0.087 inches. The 
diameter of the reduced diameter clamping cylinder 310 is identified as 
334 and is preferably 0.068 inches. The overall length is identified as 
336 and is preferably 0.700 inches. The distance from the proximal end to 
the center line of radial port 326 is identified as 338 and is preferably 
0.6183 inches. The length from the proximal end to the shoulder 318 
between counterbore 316 and main bore 314 is identified as 340 and is 
preferably 0.3456 inches. The distance from the proximal end to the 
shoulder between body 308 and crimping cylinder 310 is identified as 342 
and is preferably 0.3063 inches. The main bore 314 is preferably 0.0360 
inch and the counterbore 316 is preferably 0.0420 inch. 
Thus it is seen that the apparatus and methods of the present invention 
readily achieve the ends and advantages mentioned as well as those 
inherent therein. While certain preferred embodiments of the invention 
have been illustrated and described for purposes of the present 
disclosure, numerous changes may be made by those skilled in the art which 
changes are encompassed within the scope and spirit of the present 
invention as defined by the appended claims.