Abstract: Systems, devices, and methods for identifying a target in vivo are disclosed. A target identification system for use in electrosurgery includes a probe, an optical splitter, and a spectroscopy system. The probe includes an optical pathway to pass a first optical signal to an anatomical target and at least a portion of a second optical signal from the anatomical target. The optical splitter includes a first port to direct the first optical signal to the optical pathway and to receive the at least a portion of the second optical signal from the optical pathway, a second port to receive the first optical signal, and a parabolic reflector to redirect the portion of the second optical signal. The spectroscopy system can identify a characteristic of the anatomical target based on the redirected at least a portion of the second optical signal.

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 identifying a target in vivo are disclosed. A target identification system for use in electrosurgery includes a probe, an optical splitter, and a spectroscopy system. The probe includes an optical pathway to pass a first optical signal to an anatomical target and at least a portion of a second optical signal from the anatomical target. The optical splitter includes a first port to direct the first optical signal to the optical pathway and to receive the at least a portion of the second optical signal from the optical pathway, a second port to receive the first optical signal, and a parabolic reflector to redirect the portion of the second optical signal. The spectroscopy system can identify a characteristic of the anatomical target based on the redirected at least a portion of the second optical signal.

Abstract: Systems, devices, and methods for temperature and pressure management of an anatomic site are provided. A system can include a scope configured to provide a view of an anatomic site, an energy delivery device configured to deliver therapy energy to the anatomic site, a first irrigation conduit configured to transfer fluid to the anatomic site, a first temperature sensor situated to provide first temperature data associated with the anatomic site, and control circuitry electrically coupled to receive the first temperature data, the control circuitry being configured to adjust, based at least in part on the first temperature data, at least one of (i) a first temperature of the fluid, (ii) a flow parameter of the fluid, or (iii) a setting of the energy delivery device to manage a second temperature of the anatomic site.

Abstract: An apparatus for fragmenting a stone includes an endoscope, a laser fiber, a sheath and a detection feedback system. The endoscope includes a working channel. The working channel is configured to have a retrieval basket inserted therethrough. The sheath may include a first lumen and a second lumen. A first one of the lumen is connected to the endoscope with a shaft of the endoscope extending through the first lumen. A second one of the lumen is spaced from the shaft of the endoscope providing a channel proximate an exterior side of the shaft. The second lumen has the laser fiber inserted therethrough. The detection feedback system is configured to deliver a low energy check pulse from the laser fiber and detect a response, and configured to at least partially control delivery of a high energy laser pulse from the laser fiber to cause the stone to fragment.

Abstract: Disclosed herein is a medical device. The medical device includes a sheath, a laser fiber, a basket section, and a laser beam splitter. The laser fiber is configured to extend from an end of the sheath. The basket section includes flexible members. At least a portion of the flexible members are between the sheath and the laser fiber. The laser beam splitter is coupled to the laser fiber.

Abstract: An endoscopic medical apparatus can include an endoscope tip extender such as can be configured to extend longitudinally axially from a distal portion of an endoscope in a tapered arrangement. The tip extender can define a bore such as extending longitudinally axially within the tip extender. The tip extender can include a material that can be at least one of softer or more flexible than a material of the distal portion of the endoscope.

Abstract: A medical system is provided comprising a medical device including a handle and a mechanism for moving a distal end of the medical device; an auxiliary medical device comprising a basket retrieval device including a basket sheath disposed over a basket wire and received into a working channel of the medical device; a knob assembly in communication with the basket retrieval device, the knob assembly rotatable so that the basket sheath, wire, or both move within the working channel; and a base removably connecting the auxiliary medical device to the handle wherein the handle and the base are configured to be simultaneously gripped with a hand, and wherein the mechanism is configured to be moved with a first finger to move the distal end of the medical device and the knob assembly is configured to be rotated with a second finger to move the basket sheath wire, or both.

Abstract: A composition of a biological sample, such as tissue of a patient, can be estimated during an ablation procedure. A composition detector system can include a probe, an illumination source, and a spectrometer. A distal end of a probe can convey mechanical, acoustical, or ultrasonic energy to the tissue to ablate the tissue. The probe can extend through a working channel of a viewing scope. An illumination source can illuminate a portion of the tissue at the distal end of the probe or as the portion is being evacuated and collected for disposal. The illumination can generate response illumination from the portion of the tissue. The spectrometer can receive the response illumination, analyze the response illumination, and provide an estimate of the composition of the portion of tissue.

Abstract: Techniques for detecting depth contours of an anatomical target and for enhancing imaging of the anatomical target are provided. In an example, a reference pattern of light can be projected across an anatomical target and an image of the reflected light pattern upon the anatomical target can be captured. The captured light pattern can be analyzed to determine contour information, which can then be used to provide 3D cues to enhance a 2-dimensional image of the anatomical target.

Abstract: Techniques for identifying composition of an anatomical target using a series of different colored light sources are provided. In an example, a method can include emitting light from multiple illumination sources, receiving an illumination response from an anatomical target at an optical sensor, providing an image representative of the anatomical target, and providing spectral intensity information of the illumination response in addition to the image. Each illumination source can emit light having a range of frequencies centered about a different frequency than each other illumination source.

Abstract: Systems, devices, and methods for endoscopic mapping of a target and tracking of endoscope locations inside a subject's body during a procedure are disclosed. An exemplary system comprises an imaging system configured to capture an endoscopic image of the target that includes a footprint of an aiming beam directed at the target, and a video processor configured to identifying one or more landmarks from the captured endoscopic image and determine their respective locations relative to the aiming beam footprint, and generate a target map by integrating a plurality of endoscopic images based on landmarks identified from one or more of the plurality of endoscopic images. The target map can be used to track endoscope location during an endoscopic procedure.

Abstract: Systems, devices, and methods for automatic control of laser treatment of target structure in a body of a subject based on acoustic feedback in response to delivery of laser energy to the target are disclosed. An exemplary laser energy delivery system comprises a laser system to direct laser energy at a body target, and a controller circuit to receive an acoustic signal in response to delivery of laser energy to the target, and to measure acoustic properties from the acoustic signal. The control circuit may generate control signals for controlling the laser system to adjust laser energy output, or for controlling an actuator to adjust a position of a laser fiber distal end relative to the target to achieve a desired therapeutic effect.

Abstract: Systems and methods for controlling an energy output setting of a lithotripsy device during a lithotripsy procedure are provided. The system includes a laser or other lithotripsy device configured for facilitating the lithotripsy procedure, an irrigation system configured for supplying an irrigant such as saline to a surgical site, and a temperature sensor configured to provide temperature data associated with the irrigant. The system can modulate the energy output setting of the lithotripsy device based on an estimated temperature that is determined based at least in part on the temperature data and one or more other factors such as a current energy output setting or a flow rate of the irrigant.

Abstract: A modular endoscope system comprises an exoskeleton, a camera unit couplable to the exoskeleton, a therapeutic unit couplable to the exoskeleton, a steering unit couplable to the exoskeleton, and a control unit couplable to the exoskeleton. A method for building a modular endoscope comprises determining camera and therapeutic capabilities of the endoscope, selecting an exoskeleton for the endoscope, attaching a camera unit and therapeutic unit, if such capabilities are determined, to the selected exoskeleton to satisfy the determined capabilities, and attaching a control unit to the exoskeleton to control any camera unit and therapeutic unit attached to the exoskeleton. A method of processing modular endoscope components for performing a surgical procedure comprises identifying a patient to receive a treatment, selecting components of the endoscope to perform the treatment, treating the patient with the endoscope, and deconstructing the components of the endoscope into reusable and disposable components.

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: An elevator for an endoscope comprises a first end secured to the endoscope, a second end movable by an actuator, a flexible portion positioned between the first and second ends that is rotatable when the second end is moved by the actuator, and a guide portion extending between the flexible portion and the second end to receive an endotherapy instrument extending from the endoscope, the guide portion comprising a chute to guide the endotherapy instrument leaving the endoscope. A method of forming an elevator comprises forming from a planar sheet of material an elongate body comprising a length between first and second ends, a width, and a thickness, forming a guide body in the elongate body, bending the elongate body such that first and second lengths of the elongate body oppose each other to form an interior space, and bending the guide body to extend into the interior space.

Abstract: An endoscope can comprise a proximal section, an insertion section extending longitudinally from the proximal section and comprising an elongate tubular body disposed along an insertion section longitudinal axis and a lumen extending through the elongate tubular body, and a distal section extending from the insertion section and comprising an elevator portion comprising an elevator configured to position and orient one or more endotherapy tools extending from the lumen, and a camera module comprising an illumination unit and an imaging unit. The camera module can be positioned longitudinally spaced apart from the elevator portion in an in-line configuration, such that the insertion tube longitudinal axis passes through the elevator portion and the camera module. The camera module can be user-detachable from the elevator portion. The camera module can be cleaned and sanitized for reuse and the insertion section can be disposable.

Abstract: A lithotripter is provided that includes a lithotripsy apparatus for treatment of a urinary tract stone by fragmentation. The lithotripsy apparatus includes a lithotripsy wave guide shaft configured to transmit an energy form to at least one urinary tract stone. The lithotripter includes a sensing device configured to provide signal data for determining optimal application of energy during treatment with the lithotripsy apparatus. The lithotripter includes a processor configured to collect the signal data and provide feedback to a user. The processor has a control logic configured to determine at least one of: a) if the lithotripsy wave guide shaft is in contact with a tissue; b) if the lithotripsy wave guide shaft is in contact with a stone; c) type of stone; d) if a user is applying force in excess of a predetermined threshold; and e) physical characteristics of a stone. A method is also provided.

Abstract: A medical laser apparatus, including: an energy guide; a first energy source configured to generate energy for treating a target tissue through the energy guide; a second energy source configured to emit first and second aiming beams to a target tissue through the energy guide, the second aiming beam having at least one characteristic different from the first aiming beam; and a controller comprising hardware, the controller being configured to: receive a signal indicating an illumination mode from at least two illumination modes used by an endoscope to illuminate the target tissue; and control the second energy source to output the first or second aiming beam based on the indicated illumination mode.