Stone measurement system and related method

Abstract

A medical system is described comprising a mirror comprising a handle and a shaft defining a channel having a distal opening, a processor, at least one laser source, a first laser fiber, and a second laser fiber, wherein each of the first laser fiber and the second laser fiber is coupled to at least one laser source and extends through the shaft, and wherein a distal end of the shaft comprises an imager, a distal opening of the channel, a distal end of the first laser fiber and a distal end of the second laser fiber, and wherein each of the first laser fiber and the second laser fiber is configured to transmit the collimated light beam onto the target without altering or splitting the target.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims priority to U.S. Provisional Application No. 63 / 365,900, filed on June 6, 2022, the entire contents of which are incorporated herein by reference. Technical Field

[0003] Aspects of the present disclosure generally relate to medical systems and procedures. Particular aspects relate to medical systems and methods for measuring stone size and stone displacement from a scope. Background Art

[0004] The manner in which urinary or renal stones can be removed from a patient can depend on the size of the stone. For example, some smaller stones or stone fragments may be of an appropriate size to pass through a body lumen (e.g., the urinary tract) and be excreted from the body. However, some larger stones or residual stone fragments may need to be removed via endoscopic surgery, such as by removal devices (e.g., nitinol baskets, grabbers, etc.), or further split into smaller fragments via lithotripsy. Any residual fragments greater than 5 mm may also require subsequent reintervention to remove these fragments from the patient. Therefore, accurate stone size estimation or measurement can be an important aspect of stone removal and lithotripsy.

[0005] However, obtaining accurate measurements of stone size is a known problem with existing devices. The present disclosure may address one or more of these or other problems in the art. Summary of the invention

[0006] According to an example, a medical system includes a scope comprising a handle and a shaft defining a channel having a distal opening; a processor; at least one laser source; a first laser fiber; and a second laser fiber, wherein each of the first laser fiber and the second laser fiber is coupled to the at least one laser source and extends through the shaft, wherein a distal end of the shaft comprises an imager, the distal opening of the channel, a distal end of the first laser fiber, and a distal end of the second laser fiber, and wherein each of the first laser fiber and the second laser fiber is configured to send a collimated beam onto a target without altering or fragmenting the target.

[0007] In another example, the distal end of the first laser fiber and the distal end of the second laser fiber are located on opposite sides of the distal opening. The first laser fiber is configured to transmit a first collimated beam, and the second laser fiber is configured to transmit a second collimated beam, and the first collimated beam emitted from the distal end of the first laser fiber and the second collimated beam emitted from the distal end of the second laser fiber are parallel to each other, thereby maintaining a distance between each other that is equal to the distance between the distal ends of the first laser fiber and the second laser fiber. The first laser fiber is configured to transmit a first collimated beam of a first hue, and the second laser fiber is configured to transmit a second collimated beam of a second hue, and wherein the first hue and the second hue are different.

[0008] In another example, the processor is configured to determine a depth of a target from an imager. The processor is calibrated to store a table including a series of possible pixel distances between a collimated beam of a first laser fiber and a collimated beam of a second laser fiber, and each of the possible pixel distances is associated with a possible depth of the target from the imager. The processor is configured to determine a size of the target based on a distance between a distal end of the first laser fiber and a distal end of the second laser fiber.

[0009] In another example, the processor is configured to generate an image based on imaging data obtained from the imager and enhance the image by superimposing or overlapping shapes, cues, or graphical indicators. The processor is also configured to superimpose a circle that intersects the center of the collimated beam of the first laser fiber and the center of the collimated beam of the second laser fiber.

[0010] In another example, a first laser fiber is configured to transmit a first collimated beam and a second laser fiber is configured to transmit a second collimated beam, and the processor is configured to identify a center of the first collimated beam and a center of the second collimated beam. The processor is configured to identify the center of the first collimated beam and the center of the second collimated beam via application of a segmentation algorithm. The processor is configured to apply a hue-based threshold and / or an intensity-based threshold to identify the first collimated beam and the second collimated beam prior to applying the segmentation algorithm.

[0011] In another example, a distance between the distal end of the first laser fiber and the distal end of the second laser fiber is about 1 mm-5 mm. In another example, a distance between the distal end of the first laser fiber and the distal end of the second laser fiber is about 3 mm. In another example, the medical system further includes a third laser fiber, wherein the third laser fiber is coupled to the at least one laser source and extends through the shaft, and wherein the distal end of the shaft also includes the distal end of the third laser fiber.

[0012] According to an example, a method may include inserting a scope into a body orifice or lumen; positioning the scope near a stone within the body orifice or lumen; projecting a first collimated light beam onto the stone via a first optical fiber of the scope, and projecting a second collimated light beam onto the stone via a second optical fiber of the scope, wherein a distance between the first collimated light beam and the second collimated light beam is known; and measuring the size of the stone based on the known distance between the first collimated light beam and the second collimated light beam. The method may also include comparing the measured size of the stone with a size threshold. The method may also include determining based on the comparison result between the measured size of the stone and the size threshold: 1) the stone is of an appropriate size to pass through the body lumen; 2) the stone needs to be removed via endoscopic surgery; or 3) the stone needs to be further split into smaller fragments via lithotripsy. The method may also include enhancing an image of the stone, wherein the enhancement includes superimposing a circle, wherein the diameter of the circle is equal to the diameter of the working channel of the scope.

[0013] According to an example, a method may include projecting a first collimated light beam onto a stone within a body orifice or lumen via a first optical fiber of the scope, and projecting a second collimated light beam onto the stone via a second optical fiber of the scope; receiving image data about the stone, the first collimated light beam, and the second collimated light beam from an imager of the scope; generating a visual representation of the stone, the first collimated light beam, and the second collimated light beam from the received image data; determining a pixel distance between the first collimated light beam and the second collimated light beam based on the visual representation; and identifying a depth of the stone from the imager based on the determined pixel distance between the first collimated light beam and the second collimated light beam.

[0014] It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] The accompanying drawings are incorporated into and constitute a part of this specification. These drawings illustrate various aspects of the present disclosure, and together with the written description of the present disclosure, these aspects are used to explain the present disclosure. Each drawing describes one or more exemplary aspects according to the present disclosure, as follows:

[0016] Figure 1A An exemplary mirror is depicted.

[0017] Figure 1B Depicted Figure 1A An exemplary distal end of a mirror.

[0018] Figure 1C Depicted Figure 1B An exemplary distal face of the distal end is shown in .

[0019] Figure 2A-2B Describes from Figure 1A Example images obtained with a microscope.

[0020] Figure 3 Describes from Figure 1A An exemplary enhanced image obtained with a microscope.

[0021] Figures 4A-4C Describes from Figure 1A An exemplary process of mirror-enhanced images. DETAILED DESCRIPTION

[0022] In certain techniques, where imaging equipment is used to visualize the stone, the surgeon can manually estimate the stone size by comparing the unknown size of the stone (e.g., the maximum width perceived) to the known size of a medical scope or auxiliary instrument (e.g., the opening diameter of the removal device). These estimates are often inaccurate due to the inherent challenges associated with measuring three-dimensional objects from two-dimensional images, especially when the images have low resolution or visibility. Due to these inaccuracies, the surgeon may need to remove and / or further split more medically required stones, thereby increasing the operation time. Even more time may be wasted if the surgeon introduces a removal device based on the estimated stone size and then finds that the fragments are too large for the device, requiring the removal of the removal device and / or further splitting of the stone.

[0023] In addition to accurate stone size estimation, accurate measurement of the displacement or depth of the stone from the distal tip of the medical scope may also be important for related purposes. For example, for laser lithotripsy, the displacement of the stone from the lithotripsy device (which may extend from the distal end of the medical scope) may be an important parameter in determining the amount of laser energy to be delivered to split the stone. However, estimates of such displacement based on the imaging provided by the scope may generally be inaccurate and unreliable, which in turn may affect the delivery of laser light for lithotripsy purposes. The disclosed methods and apparatus may produce more accurate stone measurements than existing methods and apparatus.

[0024] Various aspects of the present disclosure are now described with reference to exemplary systems and methods for measuring stone size and displacement. Some aspects are described with reference to medical procedures in which a scope is guided through the body until the distal end of the scope is located in a body lumen that includes one or more stone objects. For example, the scope may include an elongated sheath that is guided through the urethra, bladder, and ureters until the distal end of the sheath is located in a renal calyx, adjacent to one or more kidney stones. Reference to specific types of procedures, such as medical procedures; body cavities, such as renal calyxes; and stone objects, such as kidney stones, are provided for convenience and are not intended to limit the present disclosure unless otherwise claimed. Accordingly, the concepts described herein may be used in connection with any similar device or method, whether medical or otherwise, whether or not specific to the kidney.

[0025] Wherever possible, the same or similar reference numerals will be used throughout the drawings to refer to the same or similar parts. The term "distal end" refers to the component farthest from the user when the device is introduced into a subject (e.g., a patient). Conversely, the term "proximal end" refers to the component closest to the user when the device is placed in the subject. Unless otherwise claimed, these terms are provided for convenience and are not intended to limit the present disclosure to a particular position, direction, or orientation.

[0026] The above general description and the following detailed description are exemplary and explanatory only and do not limit the claimed features. As used herein, the terms "comprising," "including," "having," "including," or other variations thereof are intended to cover non-exclusive inclusions such that a process, method, article, or device that includes a list of elements includes not only those elements, but may also include other elements that are not explicitly listed or inherent to such process, method, article, or device. In the present disclosure, relative terms, such as "approximately," "substantially," "generally," and "approximately," are used to indicate that the value or feature may vary by ±10%.

[0027] Embodiments of the present disclosure may address one or more limitations of the art. However, the scope of the present disclosure is defined by the appended claims rather than the ability to address a particular problem.

[0028] The present disclosure relates to a medical system comprising a medical device, namely a scope; comprising at least two laser emitters, such as optical fibers, disposed at a distal end of the scope; and a method of performing a medical procedure using the medical device. Each of the at least two laser emitters is configured to deliver a collimated light beam that can be projected or irradiated onto a targeted stone. As discussed in further detail below, the at least two collimated light beams so projected via the scope can accurately measure the size of the stone, as well as the displacement of the stone from the distal end of the scope.

[0029] Reference now Figure 1A An exemplary system 100 is described. System 100 includes a medical device, such as a scope 10, which can be connected to a device (e.g., a tower 60) that supports the medical device. Tower 60 is not particularly limited. Tower 60 can be any suitable device (such as a fixture) that is configured to operate with scope 10 and provide any necessary sources to scope 10, such as light, vacuum / suction, fluid, air / insufflation, power, signals, etc. Figure 1AAs shown, tower 60 also includes at least one processing unit 62 that can operate with the imaging unit of mirror 10 and help generate a visual representation of the image data and send the visual representation to one or more interface devices, such as screen 12. Processing unit 62 can also enhance the visual representation. Screen 12 is not particularly limited and can be any suitable display for displaying the images generated by the mirror camera and processing unit 62, such as a touch screen display.

[0030] The tower 60 may also include at least one laser 64. The laser 64 is not particularly limited and may be any suitable laser device, such as one or more laser pointers, one or more gas laser sources, one or more liquid laser sources, one or more semiconductor laser sources, one or more excimer laser sources, one or more laser diodes, etc., as well as any suitable non-laser device, such as an LED with a collimator. In some examples, the laser 64 may be of sufficiently small size so that the laser 64 may be incorporated into the mirror 20 itself, rather than in the tower 60. In some examples, one laser 64 may generate multiple (i.e., two or more) beams. In other examples, each laser 64 may generate one beam, and the tower 60 may include multiple lasers 64. The intensity, hue, and other aspects of the beams generated by the one or more lasers 64 are not particularly limited, as long as the beams can be safely irradiated on the designated target stone without changing, for example, splitting the target stone, as described below. In some examples, the one or more lasers 64 may generate a first beam having a first color and a second beam having a second color. The one or more lasers 64 may generate any suitable number of beams. All or some of the beams may have similar properties, or each of the beams may have unique properties. The one or more lasers 64 may produce a collimated beam or other type of beam. Further properties of the beams from the one or more lasers 64 are discussed in more detail below.

[0031] The tower 60 may also include any suitable or desired additional devices and / or equipment, including, for example, one or more monitors, one or more conduits, one or more cables, etc. (not shown). In addition, the arrangement of the tower 20 and its various sources, devices, etc. is not particularly limited. For example, although "tower" may mean a vertical arrangement of components / devices for supporting the apparatus 10, the components / devices may be arranged in any suitable manner, and the term "tower" is not limited to a particular arrangement.

[0032] Figures 1A-1CThe scope 10 is not particularly limited, and may be, for example, any scope (e.g., bronchoscope, duodenoscope, endoscope, colonoscope, ureteroscope, etc.), catheter, tool, instrument, etc. having a shaft / catheter extending from a handle to a distal end. In this example, the scope 10 includes: a handle 20 having a first actuator 22 and a second actuator 24; a cable 26; a port 28; and an elongated shaft 30 having a maneuverable component 32.

[0033] The handle 20 is also not particularly limited and can be any suitable medical device handle. The first actuator 22 is not particularly limited and can be any suitable control, for example, by applying force to a pull wire contained in the shaft 30 to articulate the steerable member 32. For example, the first actuator 22 may include a lever, such as Figure 1A Alternatively, the first actuator may include, for example, a knob, a slider, a joystick, a button, or any other type of mechanism. Likewise, the second actuator 24 is also not particularly limited and may be used for other suitable purposes, such as actuating or controlling other aspects of the mirror 10, such as turning the laser 64 on / off, performing image capture, or operating any tools or auxiliary instruments associated with the mirror 10. For example, the second actuator 24 may include a button, such as Figure 1A Alternatively, the first actuator may include, for example, a knob, a slider, a joystick, a lever, or any other type of mechanism.

[0034] like Figure 1A As shown, the cable 26 (e.g., an umbilical cord) is connected to one face of the tower 60. For example, the proximal end of the cable 26 can terminate in a connector configured to mate with a receptacle of the tower 60. The cable 26 is not particularly limited and can include any suitable wiring / sheathing suitable for a variety of purposes. For example, the cable 26 can be configured to wrap a sheath around various cables and wiring (not shown) that transmit imaging data from the imager 42 (e.g., Figure 1B-1C As shown) is sent to the processing unit 62. In addition (or alternatively), the cable 26 can wrap a sheath around laser fibers, such as a first laser fiber 43 and a second laser fiber 45. The laser fibers 43, 45 may include holmium fibers, or other types of laser fibers or fibers with collimators. Each of the first laser fiber 43 and the second laser fiber 45 can be removably coupled to one or more laser sources 64 via, for example, a connector at the proximal end of the cable 26. For example, one or more of the connectors of the cable 26 or the sockets of the tower portion 12 may include a laser to fiber coupler. Such a coupler is not particularly limited and may include any weld or intermediate lens that may facilitate coupling between the optical fibers 43, 45 and the laser source 64. The first laser fiber 43 and the second laser fiber 45 (as shown) may be sheathed around the laser fibers, such as a first laser fiber 43 and a second laser fiber 45. The laser fibers 43, 45 may include holmium fibers, or other types of laser fibers or fibers with collimators. Each of the first laser fiber 43 and the second laser fiber 45 may be removably coupled to one or more laser sources 64 via, for example, a connector at the proximal end of the cable 26. For example, one or more of the connectors of the cable 26 or the sockets of the tower portion 12 may include a laser to fiber coupler. Such a coupler is not particularly limited and may include any weld or intermediate lens that may facilitate coupling between the optical fibers 43, 45 and the laser source 64. Figure 1B and 1CThe first and second laser fibers 43 and 45 can each be configured to send a collimated beam (or other type of beam) from the laser source 64 to the distal ends of the first and second laser fibers 43 and 45, respectively. As discussed in further detail below, the first and second laser fibers 43 and 45 can extend through the handle 20 toward the distal end 30D of the shaft 30. Although Figure 1B and 1C Two laser fibers 43, 45 are shown in FIG, but it should be understood that any suitable number of laser fibers may be used. For example, three, four, five, or more laser fibers may be used. In at least some examples, including two or more laser fibers 43, 45 may be advantageous.

[0035] like Figure 1A As shown, the port 28 can be mounted on the distal end portion of the handle 20 and includes a working channel 34 (eg, Figure 1B-1C Any suitable auxiliary instrument / device or elongated tool (e.g., lithotripsy equipment, graspers, retrieval equipment, etc.) can be inserted through port 28 and moved distally through the distal end component of handle 20 and / or working channel 34.

[0036] like Figure 1A-1B As shown, the elongated shaft 30 extends distally from the handle 20 before terminating at the distal end 30D of the shaft 30. The shaft 30 is not particularly limited and can be any suitable flexible shaft configured to pass through a body lumen during surgery. As described above, the shaft 30 can include a maneuverable / articulating component 32 adjacent to the distal end 30D. The component 32 is not particularly limited and can be any standard articulating component of a medical scope shaft.

[0037] The shaft 12 may also include at least one working channel 34 that may extend longitudinally from the port 28 of the handle 20 to the distal end 30D of the shaft 30. The shaft 30 may also include at least one or more lumens for receiving any number of additional wiring, cables, and / or optical fibers from the tower 60 that support various features present on the distal end 30D of the shaft 30, as will be discussed in further detail below. The laser fibers 43, 45 may extend from the cable 26, through the interior of the handle 20, and through the shaft 30. For example, the laser fibers 43, 45 may extend through one or more lumens of the shaft 30 or through a central opening defined by an outer sheath of the shaft 30. For example, each of the first laser fiber 43 and the second laser fiber 45 may include a single continuous, single piece of optical fiber extending from a connector of the cable 26 to the distal end 30D. Alternatively, one or both of the first laser fiber 43 and the second laser fiber 45 may include multiple pieces that are in optical communication with each other (e.g., joined or fused together by a connector).

[0038] like Figure 1B and 1C As shown, the distal end 30D of the shaft 30 may include at least the distal opening of the working channel 34, the imager 42, the light 46, and the distal ends of the laser fibers 43, 45. In other examples, the shaft 30 may also include a distal cover (not shown) covering the components of the distal end 30D, thereby protecting features such as the imager 42, the light 46, and the laser fibers 43, 45.

[0039] The distal opening of the working channel 34 is not particularly limited and can be any suitable width to enable the instrument or tool to be extended / retracted in / out of the working channel 34. The imager 42 is also not particularly limited and can be any suitable device that is configured to receive imaging data of a designated target (e.g., a stone) (e.g., via any sensor) and send the imaging data to an image processor (such as the processing unit 62) to generate a visual representation of the imaging data. In some examples, the imager 42 can be a camera including a CMOS sensor. In other examples, the imager 42 can include an optical fiber that communicates with a sensor or other device that can be positioned in the shaft 30 or the handle 20. However, the imager 42 is not limited to the above examples. The light 46 is also not particularly limited and can be any suitable device configured to provide a light source, particularly when the shaft 30 is passing through a body lumen and the imager 42 is capturing imaging data of a designated target. In some examples, the light 46 can include a plastic optical fiber ("POF") device configured to provide light from a light source of the tower 12, such as an LED or an LED mounted at the distal end 30D.

[0040] like Figure 1B and 1CAs shown, the distal tips / ends of the first laser fiber 43 and the second laser fiber 45 can be present on the distal end 30D of the shaft 30. As described above, although two laser fibers are depicted in the shaft 30, the number of laser fibers is not particularly limited, as long as there is available space in the shaft 30 / on the distal end 30D to accommodate additional laser fibers. In some examples, the system 100 may also include a third laser fiber, a fourth laser fiber, etc. As described above, the laser fibers 43 and 45 are not particularly limited and can be any suitable optical fiber for laser transmission. As described above, the optical fibers 43 and 45 can communicate with the laser source 64 of the tower 60. One or more laser sources 64 can send or project a collimated beam that can pass through the optical fibers 43, 45. The optical fibers 43 and 45 can be located on opposite sides of the distal opening of the working channel 34. For example, the optical fibers 43 and 45 can each be adjacent to the distal opening of the working channel 34 on opposite sides of the distal opening of the working channel 34. A line drawn through the optical fibers 43 and 45 may substantially intersect the central axis of the distal opening of the working channel 34. However, the positions of the optical fibers 43 and 45 on the distal end 30D are not limited thereto.

[0041] The distance or displacement between the center of optical fiber 43 and the center of optical fiber 45 (eg Figure 1C The distance A shown can be predefined. For example, the axis 30 can be configured so that the displacement between the optical fiber 43 and the optical fiber 45 can be any predefined distance A, such as 1mm, 2mm, 3mm, 4mm, 5mm, 6mm, 7mm, etc. If additional optical fibers are used, the distal ends of the optical fibers can be positioned in any suitable manner. For example, the distal ends of the optical fibers can be positioned around the distal opening of the working channel 34. The distance between each of the optical fibers can be equal (e.g., distance A) or can vary. The optical fibers 43 and 45 can send parallel collimated light beams, and the distance A between the light beams is consistent regardless of the distance the collimated light beams are sent.

[0042] This consistent, predetermined distance A between the center of the first laser fiber 43 and the center of the second laser fiber 45 can be used to accurately measure or estimate the size of the target stone. Figure 2A An example of this process is shown in . Figure 2AAn exemplary image 80 captured via the imager 42 is shown, which may be displayed on the screen 12. When generating the image 80, the distal end 30D of the scope 10 (and therefore the imager 42) was positioned approximately 5 mm from the target stone 300, which may be approximately spherical with a diameter of about 1 / 8 inch. A first collimated beam 432 is sent to the stone 300 via the first laser fiber 43, and a second collimated beam 452 is sent to the stone 300 via the second laser fiber 45. The first collimated beam 432 and the second collimated beam 452 may be sent to the stone 300 such that the beams 432, 452 may be along a dimension of the stone 300, such as the long axis of the stone 300. The center of the first collimated beam 432 and the center of the second collimated beam 452 are separated by a distance A (e.g., 3 mm), which is approximately equal to the spacing between the first laser fiber 43 and the second laser fiber 45 at the distal end 30D. Therefore, assuming that the user, tower 12, and / or another element of system 100 knows distance A, and that distance A (i.e., 3 mm) is approximately equal to Figure 3 If the diameter of the target stone 300 in the view A is 1 / 8 inch (or 3.175 mm), the size of the stone 300 can be approximately accurately evaluated / estimated to determine how the stone can be removed or whether lithotripsy is required. For example, the processing unit 62 of the tower 12 or another aspect of the system 100, or a user in the system 100, can estimate the size of the stone 300 based on the known distance A. The user or the processing unit 62 can then compare the size of the stone 300 with one or more preset size thresholds. Based on the results of this comparison, the user or the processing unit 62 can determine, for example, that the stone is of an appropriate size to pass through the body lumen and needs to be removed via endoscopic surgery, or needs to be further split into smaller fragments via lithotripsy. An exemplary process by which the processing unit 62 may determine the size of the stone 300 may include implementing any suitable image segmentation technique / algorithm to determine the pixel distance of the long axis of the stone 300 and the pixel distance of the distance A, which may be along the long axis of the stone 300, and calculating the ratio between the pixel distance of the long axis of the stone 300 and the pixel distance A. For example, the long axis of the stone 300 in the image 80 may be 300 pixels, while the distance A may be 200 pixels in the image 80. In this example, the actual physical distance of the distance A may be 3 mm, which is equal to the spacing between the first laser fiber 43 and the second laser fiber 45 on the distal end 30D. Therefore, the processing unit 62 may calculate the size of the stone 300 by multiplying the above-mentioned pixel distance ratio between the long axis of the stone 300 and the distance A by the actual physical distance of the distance A, i.e. In discussion Figures 4A-4C , identifying the center of a collimated light beam for various purposes, such as determining a pixel distance from distance A, will be discussed further below.

[0043] It should be noted that in images (e.g. Figure 2B 82), when the distal end 30D is further away from the stone 300 on which the light beams 432 and 452 are projected, the light beams 432 and 452 of the optical fibers 43 and 45 may be dispersed. However, since the light beams 432 and 452 are collimated, the actual distance between the centers of the light beams 432 and 452 always remains the distance A. Therefore, the scope 10 can be adjusted relative to the stone 300 until the light beams 432 and 452 are positioned on either side of the stone 300 (e.g., Figure 2A and 2B as shown) or along any face or dimension of the stone 300 to be measured.

[0044] Additionally, in other examples where the width of the stone 300 significantly exceeds the predetermined distance A, the user can repeatedly reposition the mirror 10 so that the collimated beams 432 and 452 are tracked across the size of the stone 300, such as the width of the stone 300, to measure the width as with a typical measuring instrument. For example, when the width or diameter of the stone 300 is approximately twice the distance A, the user can first position the mirror 10 so that the center of the beam 432 is aligned or approximately aligned with the center of the stone 300, and the center of the beam 452 is aligned or approximately aligned with a first point along the edge of the stone 300. The user can then reposition the mirror 10 so that the center of the beam 452 is aligned or approximately aligned with the center of the stone 300, and the center of the beam 432 is aligned or approximately aligned with a second point along a face of the stone 300 diametrically opposite the first point. The user can repeat this repositioning and measuring until a substantially accurate assessment / estimate of the size of the stone 300 can be made based on the known distance of the distance A and the number of repositionings required to measure the size of the stone 300.

[0045] Figure 2B Another exemplary image 82 is shown captured via the imager 42 and displayed on the screen 12. In the image 82, the distal end 30D of the scope 10 (and therefore the imager 42) is positioned approximately 10 mm from the target stone 300. Despite the additional displacement between the distal end 30D and the stone 300 shown relative to the image 80, the distance between the beams 432 and 452 remains the same distance A given the collimated nature of the beams.

[0046] However, if Figure 2A and 2BAs shown, the pixel distance (i.e., distance B) between the first collimated light beam 432 and the second collimated light beam 452 in image 80 is different from the pixel distance (i.e., distance C) between the first collimated light beam 432 and the second collimated light beam 452 in image 82. The processing unit 62 can measure the pixel distance via any suitable means. This difference between distance B and distance C can be attributed to the difference in displacement or depth of the stone 300 from the distal end 30D of the scope 10. This difference in pixel distance can also be used to measure or estimate the depth of the stone 300 from the distal end 30D of the scope 10. For example, the pixel distance between at least two beams (e.g., beam 432 and beam 452) within an image (e.g., image 80 or image 82) can be calibrated to the depth of the stone from the imager 42 (and therefore, the distal end 30D of the scope 10). Such calibration may be performed via any suitable means, for example, a table (e.g., a lookup table) may be created and stored within the processing unit 62 and may include a series of pixel distances, each pixel distance being associated with a particular depth of the imaging target from the imager 42, such as 1 pixel-20 mm, 2 pixels-10 mm, 3 pixels-6 mm, 5 pixels-4 mm, 10 pixels-3 mm, 20 pixels-2 mm, 100 pixels-0.5 mm, etc. The lookup table may be created during a calibration process, such as in a laboratory setting with externally measured depth information. Thus, a user or the processing unit 62 may identify a pixel distance (e.g., distance B or distance C) between the first collimated beam 432 and the second collimated beam 452 based on the table, and subsequently identify the depth associated with the aforementioned pixel distance. Thus, the scope 10 may be used to measure the size of the stone 300 and the depth of the stone 300 from the distal end 30D of the scope 10.

[0047] like Figure 3 As shown, an image 84 including the stone 300, the first collimated light beam 432, and the second collimated light beam 452 can be enhanced. The manner in which the image 84 can be enhanced is not particularly limited. For example, the enhancement of the image 84 can include: sending image data of the stone 300 and the surrounding body lumens or cavities from the imager 42 to the processing unit 62; generating a visual representation of the stone 300 and the surrounding body lumens or cavities from the image data using the processing unit 62; and enhancing the visual representation by superimposing or overlapping shapes (e.g., circle 602, graphic prompts, graphic indicators, etc.), thereby producing the image 84. In some examples, the image 84 can be a real-time, live visual representation of the stone 300 and the surrounding body lumens or cavities, and the enhancement can be applied to the real-time visual representation.

[0048] In some examples, the enhancement of the above-described image 84 can be used for stone size measurement / assessment purposes. For example, as described above, a circle 602 can be superimposed / overlaid on the image 84 via the processor. The circle 602 can have a known diameter (e.g., 1 mm, 5 mm) or the diameter of the distal opening of the working channel 34, so that the user or the processing unit 62 can cross-reference the size of the stone 300 with the diameter of the circle 602, for example, to determine whether the stone 300 can be captured and removed via the working channel 34, or whether the stone 300 needs to be split. The processing unit 62 can overlay the circle 602 by first determining the pixel distance corresponding to the actual physical diameter of the distal opening of the working channel 34. The pixel distance can be determined by the known distance of the distance A and the known diameter of the distal opening of the working channel 34. For example, the processing unit 62 can recognize that the distance A is, for example, 3 mm, the access sheath is, for example, 4 mm in diameter, and therefore, determine that the size (i.e., the pixel distance) of the circle 602 is 4 / 3 of the pixel distance of the distance A in the image 84.

[0049] Figures 4A-4C 4 shows an exemplary process by which the center of the first collimated light beam 432 and the center of the second collimated light beam 452 can be determined. In some examples, the color / hue of the first collimated light beam 432 and the second collimated light beam 452 can vary, such as a red light beam 432 and a green light beam 452. Given this difference, the processing unit 62 can apply a threshold based on hue (e.g., a threshold based on red hue) to identify the first collimated light beam 432, such as Figure 4A As shown. Thereafter, the collimated light beam 432 may be segmented via the processing unit 62. The manner in which the light beam 432 is segmented is not particularly limited and may be via any suitable image segmentation algorithm. The processing unit 62 may then apply a threshold based on a second hue (e.g., a threshold based on a green hue) to identify the second collimated light beam 452, such as Figure 4B As shown. Thereafter, the collimated beam 452 may be segmented via the processing unit 62. The manner in which the beam 452 is segmented is also not particularly limited, and may be via any suitable image segmentation algorithm. It is noteworthy that additional image processing techniques (e.g., intensity-based thresholds) may also be implemented to assist in the segmentation process described above. After the beams 432 and 452 are segmented, the centers of the beams 432 and 452 may be determined via any suitable means (e.g., a centroid calculation). Assuming that each pixel in the segmented beams 432 and 452 has (x, y) coordinates, the processing unit 62 may obtain all coordinates of the segmented beams 432 and 452 to calculate the centers of the segmented beams. An exemplary centroid calculation may be: Where (X c , Y c ) is the center of the laser spot, and N is the total number of pixels in segmented beam 432 or beam 452.

[0050] Although the principles of the present disclosure are described herein with reference to the illustrative aspects of specific applications, the present disclosure is not limited thereto. Those of ordinary skill in the art and those who have access to the teachings provided herein will recognize that additional modifications, applications, aspects, and replacements of equivalents all fall within the scope of the aspects described herein. Therefore, the present disclosure should not be considered to be limited by the above description.

Claims

1. A medical system comprising: a scope comprising a handle and a shaft defining a channel having a distal opening; processor; at least one laser source; First laser fiber; and a second laser fiber, wherein each of the first laser fiber and the second laser fiber is coupled to the at least one laser source and extends through the axis, wherein the distal end of the shaft includes an imager, a distal opening of the channel, a distal end of the first laser fiber, and a distal end of the second laser fiber, and Each of the first laser fiber and the second laser fiber is configured to send a collimated light beam to a target without changing or splitting the target.

2. The medical system of claim 1, wherein the distal end of the first laser fiber and the distal end of the second laser fiber are located on opposite sides of the distal opening.

3. The medical system according to claim 1 or 2, wherein: The first laser fiber is configured to transmit a first collimated light beam, and the second laser fiber is configured to transmit a second collimated light beam, and wherein the first collimated light beam emitted from the distal end of the first laser fiber and the second collimated light beam emitted from the distal end of the second laser fiber are parallel to each other, thereby maintaining a distance therebetween that is equal to a distance between the distal ends of the first laser fiber and the second laser fiber.

4. A medical system according to any one of the preceding claims, wherein: The first laser fiber is configured to transmit a first collimated light beam of a first hue, and the second laser fiber is configured to transmit a second collimated light beam of a second hue, and wherein the first hue and the second hue are different.

5. The medical system of any of the preceding claims, wherein the processor is configured to determine a depth of the target point from the imager.

6. The medical system of claim 5, wherein the processor is calibrated to store a table comprising a series of possible pixel distances between the collimated beam of the first laser fiber and the collimated beam of the second laser fiber, and each of the possible pixel distances is associated with a possible depth of the target from the imager.

7. The medical system of claim 6, wherein the processor is configured to determine the size of the target spot based on a distance between a distal end of the first laser fiber and a distal end of the second laser fiber.

8. A medical system according to any of the preceding claims, wherein the processor is configured to generate an image based on imaging data obtained from the imager and to enhance the image by superimposing or overlapping shapes, cues or graphical indicators.

9. The medical system of claim 8, wherein the processor is further configured to superimpose a circle that intersects a center of the collimated beam of the first laser fiber and a center of the collimated beam of the second laser fiber.

10. The medical system of any of the preceding claims, wherein the first laser fiber is configured to transmit a first collimated beam and the second laser fiber is configured to transmit a second collimated beam, and the processor is configured to identify a center of the first collimated beam and a center of the second collimated beam.

11. The medical system of claim 10, wherein the processor is configured to identify a center of the first collimated light beam and a center of the second collimated light beam via application of a segmentation algorithm.

12. The medical system of claim 11, wherein the processor is configured to apply a hue-based threshold and / or an intensity-based threshold to identify the first collimated light beam and the second collimated light beam prior to applying the segmentation algorithm.

13. The medical system of any one of the preceding claims, wherein the distance between the distal end of the first laser fiber and the distal end of the second laser fiber is about 1 mm to about 5 mm.

14. The medical system of any one of the preceding claims, wherein the distance between the distal end of the first laser fiber and the distal end of the second laser fiber is approximately 3 mm.

15. The medical system of any of the preceding claims, further comprising a third laser fiber, wherein the third laser fiber is coupled to the at least one laser source and extends through the shaft, and wherein the distal end of the shaft also comprises the distal end of the third laser fiber.

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