Abstract: The present disclosure relates generally to dual-function medical devices with diagnostic and therapeutic capabilities, such as real-time visualization and ablation. Many embodiments may include an ergonomic handle and dual-lumen catheter configured for dual-function diagnostic and therapeutic use during a medical procedure, such as a duodenoscope. The medical device may be delivered within an endoscope working channel to provide real-time visualization (e.g., radial ultrasound imaging) and treatment (e.g., soft tissue ablation) of cancerous tissue. For instance, a first lumen may include a high-frequency linear or radial ultrasound and the second lumen may include a surgical instrument, such as an ablation tool. Some embodiments may include a controller with a feedback loop configured to adjust the therapeutic tool based on data from the diagnostic tool. For instance, the power of an ablation tool may be adjusted by the controller based on data generated by an imaging device.

Abstract: A lithotripsy or other medical laser treatment system can include a lateral actuator to laterally displace a distal portion of a laser fiber, such as can be scanned or otherwise controlled to generate a spatial or spatiotemporal sub-targeting pattern without requiring laterally moving an endoscope carrying the laser fiber in a longitudinal passage such as a working channel. A targeted stone can be selectively weakened along the pattern, such as using lower energy pulses, before being fragmented, such as by a higher energy shock pulse.

Abstract: A probe of a target identification system can be extended via a first lumen of a viewing instrument, such as for illuminating an area beyond a distal end of the viewing instrument via an optical path of the viewing instrument. An optical response to the illumination of the area can be received via an optical path of the probe and can be split from other optical signals of the optical path. The optical response information can be used to identify characteristics of a target and to adjust parameters of a working instrument such as a working instrument contemporaneously using the probe.

Abstract: A probe of a target identification system can be extended via a first lumen of a viewing instrument, such as for illuminating an area beyond a distal end of the viewing instrument via an optical path of the viewing instrument. An optical response to the illumination of the area can be received via an optical path of the probe and can be split from other optical signals of the optical path. The optical response information can be used to identify characteristics of a target and to adjust parameters of a working instrument such as a working instrument contemporaneously using the probe.

Abstract: Systems, devices, and methods for delivering laser energy to a target in an endoscopic procedure are disclosed. An exemplary method comprises providing a first laser pulse train and a different second laser pulse train emitting from a distal end of an endoscope and incident on a target. The first laser pulse train has a first laser energy level, and the second laser pulse train has a second laser energy level higher than the first laser energy level. In an example, the first laser pulse train is used to form cracks on a surface of a calculi structure, and the second laser pulse train causes fragmentation of the calculi structure after the cracks are formed.

Abstract: A probe of a target identification system can be extended via a first lumen of a viewing instrument, such as for illuminating an area beyond a distal end of the viewing instrument via an optical path of the viewing instrument. An optical response to the illumination of the area can be received via an optical path of the probe and can be split from other optical signals of the optical path. The optical response information can be used to identify characteristics of a target and to adjust parameters of a working instrument such as a working instrument contemporaneously using the probe.

Abstract: A multifiber assembly and methods of using the same in an endoscopic procedure for transmitting illumination light to, and a response signal reflected from, a target is disclosed. An exemplary device comprises a proximal end, and distal end, and a transition section between the proximal and distal ends. The proximal end includes a first connector to be connected to a light source and a second connector configured to be connected to a spectrometer. The distal end includes a shaft including at least two first optical fibers to transmit light and at least one second optical fiber to transmit a spectroscopic signal. The transition section can couple the first connector to the at least two first optical fibers, and to couple the second connector to the at least one second optical fiber.

Abstract: Systems, devices, and methods for delivering laser energy to a target in an endoscopic procedure are disclosed. An exemplary method comprises providing a first laser pulse train and a different second laser pulse train emitting from a distal end of an endoscope and incident on a target. The first laser pulse train has a first laser energy level, and the second laser pulse train has a second laser energy level higher than the first laser energy level. In an example, the first laser pulse train is used to form cracks on a surface of a calculi structure, and the second laser pulse train causes fragmentation of the calculi structure after the cracks are formed.

Abstract: A multifiber assembly and methods of using the same in an endoscopic procedure for transmitting illumination light to, and a response signal reflected from, a target is disclosed. An exemplary device comprises a proximal end, and distal end, and a transition section between the proximal and distal ends. The proximal end includes a first connector to be connected to a light source and a second connector configured to be connected to a spectrometer. The distal end includes a shaft including at least two first optical fibers to transmit light and at least one second optical fiber to transmit a spectroscopic signal. The transition section can couple the first connector to the at least two first optical fibers, and to couple the second connector to the at least one second optical fiber.

Abstract: System and methods for controlling a laser light source of a lithotripsy device to fragment or break a target object are disclosed. An exemplary system includes a controller that can perform one or more iterations of a first process and one or more iterations of a second process. The first process includes steps of selecting at least one variable operating parameter of a laser light source of a lithotripsy device; determining a value of each of a plurality of base settings of the at least one variable operating parameter selected; and selecting one of the plurality of base settings based on signals received from the target in response to laser irradiation according to the value of each of the plurality of base settings set. The second process includes controlling the laser light source based on the one of the plurality of base settings selected.

Abstract: System and methods for controlling a laser light source of a lithotripsy device to fragment or break a target object are disclosed. An exemplary system includes a controller that can perform one or more iterations of a first process, and one or more iterations of a second process. The first process includes steps of selecting at least one variable operating parameter of a laser light source of a lithotripsy device, determining a value of each of a plurality of base settings of the at least one variable operating parameter selected and selecting one of the plurality of base settings based on signals received from the target in response to laser irradiation according to the value of each of the plurality of base settings set. The second process includes controlling the laser light source based on the one of the plurality of base settings selected.

Abstract: Systems, devices, and methods for identifying a target in a body using a spectroscopic feedback from the target are disclosed. An exemplary surgical feedback control system comprises a feedback analyzer configured to receive a reflected signal from a target in response to electromagnetic radiation directed at a target, and a controller in operative communication with the feedback analyzer. The controller can generate a control signal to a surgical system to perform a predetermined operation based upon the received reflected signal, including determining a composition of the target, or programming a laser setting to direct laser energy to the target.

Abstract: Systems, devices, and methods for identifying different structure types with distinct composition in vivo and adjusting surgical laser output accordingly in a medical procedure are disclosed. An exemplary laser treatment system comprises a laser system configured to generate a laser beam for delivery to a target in a body, and a controller circuit configured to receive a signal reflected from the target in response to electromagnetic radiation produced by a light source, and generate one or more spectroscopic properties from the reflected signal. The controller circuit can identify the target as one of a plurality of structure types, such as tissue types or calculi types with respective compositions, using the one or more spectroscopic properties. The laser system can be controlled to operate in an operating mode based on the target identification.

Abstract: Systems, devices, and methods for identifying a target during an endoscopic procedure are disclosed. An endoscopic target identification system includes an endoscope having an endoscopic illumination source, an optical fiber insertable through a working channel of the endoscope and coupled to a non-endoscopic illumination source different from the endoscopic illumination source, and a controller. The controller can send a control signal to the non-endoscopic illumination source to emit a diagnostic beam through the optical fiber when the at least one endoscopic illumination source changes from a first mode to a second mode. The second mode has a lower amount of illumination than the first mode. The controller can determine a composition of a target based on the diagnostic beam incident on the target and light from the diagnostic beam being reflected from the target.

Abstract: Systems, devices, and methods for identifying different structure types with distinct composition in vivo and adjusting surgical laser output accordingly in a medical procedure are disclosed. An exemplary laser treatment system comprises a laser system configured to generate a laser beam for delivery to a target in a body, and a controller circuit configured to receive a signal reflected from the target in response to electromagnetic radiation produced by a light source, and generate one or more spectroscopic properties from the reflected signal. The controller circuit can identify the target as one of a plurality of structure types, such as tissue types or calculi types with respective compositions, using the one or more spectroscopic properties. The laser system can be controlled to operate in an operating mode based on the target identification.

Abstract: Systems, devices, and methods for determining a distance between a distal end of an endoscope and a target during an endoscopic procedure are disclosed. A surgical laser feedback control system comprises a feedback analyzer and a controller. The feedback analyzer can receive at least two reflected signals from a target in response to electromagnetic radiation directed at the target. The at least two reflected signals correspond to respective different distances between a distal end of a device of a surgical laser system and the target. The feedback analyzer can determine a distance between the distal end of the device of the surgical laser system and the target based on the at least two reflected signals. The controller can generate a control signal to the surgical laser system to perform a predetermined operation based on the determined distance.

Abstract: Systems, devices, and methods for identifying a target during an endoscopic procedure are disclosed. An endoscopic target identification system includes an endoscope having an endoscopic illumination source, an optical fiber insertable through a working channel of the endoscope and coupled to a non-endoscopic illumination source different from the endoscopic illumination source, and a controller. The controller can send a control signal to the non-endoscopic illumination source to emit a diagnostic beam through the optical fiber when the at least one endoscopic illumination source changes from a first mode to a second mode. The second mode has a lower amount of illumination than the first mode. The controller can determine a composition of a target based on the diagnostic beam incident on the target and light from the diagnostic beam being reflected from the target.

Abstract: Systems, devices, and methods for determining a distance between a distal end of an endoscope and a target during an endoscopic procedure are disclosed. A surgical laser feedback control system comprises a feedback analyzer and a controller. The feedback analyzer can receive at least two reflected signals from a target in response to electromagnetic radiation directed at the target. The at least two reflected signals correspond to respective different distances between a distal end of a device of a surgical laser system and the target. The feedback analyzer can determine a distance between the distal end of the device of the surgical laser system and the target based on the at least two reflected signals. The controller can generate a control signal to the surgical laser system to perform a predetermined operation based on the determined distance.

Abstract: Systems, devices, and methods for delivering laser energy directed toward target tissue using a spectroscopic feedback. An exemplary laser feedback control system comprises a feedback analyzer to receive a signal from a target tissue using a spectroscopic sensor, and a laser controller to determine whether the received signal generally equals a first preset. If the received signal meets the first preset, the laser controller can send a control signal to a laser system to change from a first state to a second state of the first laser system. The laser system can deliver laser energy via an optical fiber towards the target tissue.

Abstract: Systems, devices, and methods for delivering laser energy directed toward target tissue using a spectroscopic feedback. An exemplary laser feedback control system comprises a feedback analyzer to receive a signal from a target tissue using a spectroscopic sensor, and a laser controller to determine whether the received signal generally equals a first preset. If the received signal meets the first preset, the laser controller can send a control signal to a laser system to change from a first state to a second state of the first laser system. The laser system can deliver laser energy via an optical fiber towards the target tissue.