Fiber Bragg grating for endoscope

Abstract

In a surgical system, an endoscope can extend distally toward a target site. A sensing fiber extending to a distal end portion of the endoscope may include a fiber Bragg grating disposed at a distal end portion of the sensing fiber. The sensing controller may direct the sensing light distally along the sensing fiber such that at least some of the sensing light is reflected from the fiber Bragg grating as reflected light. The sensing controller may perform an optical frequency domain reflection measurement on the reflected light to determine a parameter value at the fiber Bragg grating, such as a pressure value or a temperature value. Processing circuitry may analyze the parameter value to determine that a parameter, such as pressure or temperature, at the target site satisfies a specified condition, such as too high, and in response, generate an alarm data signal or perform an appropriate task.

Description

[0001] Cross-references to related applications

[0002] This application claims the benefit of U.S. Provisional Application No. 63 / 465172, filed May 9, 2023, and U.S. Provisional Application No. 63 / 558352, filed February 27, 2024, the entire contents of which are incorporated herein by reference. Technical Field

[0003] This application relates generally to endoscopic systems, and more specifically to systems and methods for determining and controlling the distance between the end of a medical device and a target. Background Technology

[0004] Operators such as doctors, practitioners, or users can use endoscopes to provide visual access to a patient's internal location. The operator inserts the endoscope into the patient's body. The endoscope directs light towards the target being examined, such as the target anatomical structure or object. The endoscope collects the light reflected from the object. This reflected light can carry information about the target being examined.

[0005] An endoscope may include a working channel through which an operator can perform aspiration. The operator can also pass instruments such as brushes, biopsy needles, or forceps through the working channel. The operator can perform minimally invasive procedures through the working channel, such as removing unwanted tissue or foreign bodies from the patient's body.

[0006] Endoscopic procedures can utilize laser or plasma systems for laser treatments such as ablation, coagulation, vaporization, fragmentation, and lithotripsy. In laser treatment, the operator can use an endoscope to deliver surgical laser energy to various target treatment areas, such as soft or hard tissue. In lithotripsy, the operator can use an endoscope to deliver surgical laser energy to break up stone structures in the patient's kidneys, gallbladder, ureters, or other stone-forming areas, or to ablate large stones into smaller fragments. Summary of the Invention

[0007] In one example, a surgical system can include: a scope configured to extend distally toward a target site; a sensing optical fiber extending to a distal end portion of the scope and including a fiber Bragg grating arranged at a distal end portion of the sensing optical fiber; a sensing controller configured to: direct sensing light distally along the sensing optical fiber such that at least some of the sensing light is reflected as reflected light from the fiber Bragg grating; perform an optical frequency domain reflectometry on the reflected light; and determine, from the optical frequency domain reflectometry, a parameter value at the fiber Bragg grating; and processing circuitry configured to: analyze the parameter value; determine, from the analysis of the parameter value, that a parameter at the target site satisfies a specified condition; and generate, in response to the determination that the parameter at the target site satisfies the specified condition, an alert data signal.

[0008] In one example, a surgical system can include: a scope configured to extend distally toward a target site and to provide an insufflation medium to the target site; a sensing optical fiber extending to a distal end portion of the scope and including a fiber Bragg grating arranged at a distal end portion of the sensing optical fiber; a sensing controller configured to: direct sensing light distally along the sensing optical fiber such that at least some of the sensing light is reflected as reflected light from the fiber Bragg grating; perform an optical frequency domain reflectometry on the reflected light; and determine, from the optical frequency domain reflectometry, a pressure value at the fiber Bragg grating; and processing circuitry configured to: compare the pressure value to a threshold pressure value; determine, from the comparison, that the pressure value exceeds the threshold pressure value; and in response to the determination that the pressure value exceeds the threshold pressure value, cause the scope to perform at least one of: provide an alert to a user to reduce a pressure of the insufflation medium; or automatically reduce the pressure of the insufflation medium.

[0009] In one example, a surgical system can include: a scope configured to extend distally toward a target site, to provide a therapeutic laser to the target site, and to provide an irrigant to the target site, the scope including a cooling element configured to controllably cool the target site; a sensing optical fiber extending to a distal end portion of the scope and including a fiber Bragg grating arranged at a distal end portion of the sensing optical fiber; a sensing controller configured to: direct sensing light distally along the sensing optical fiber such that at least some of the sensing light is reflected as reflected light from the fiber Bragg grating; perform an optical frequency domain reflectometry measurement on the reflected light; and determine, from the optical frequency domain reflectometry measurement, a temperature value at the fiber Bragg grating; and processing circuitry configured to: compare the temperature value to a threshold temperature value; determine, from the comparison, that the temperature value exceeds the threshold temperature value; and in response to determining that the temperature value exceeds the threshold temperature value, cause the scope to perform at least one of: provide an alert to a user that the temperature at the target site can be too high; automatically reduce a power of the therapeutic laser; automatically increase a flow rate of the irrigant; or automatically activate the cooling element. BRIEF DESCRIPTION OF DRAWINGS

[0010] Various implementations are illustrated by way of example in the drawings and are described in detail below. Such implementations are exemplary and not intended to be exclusive or exhaustive.

[0011] Figure 1 A side view schematic of an example of a surgical system is shown.

[0012] Figure 2 A flowchart of an example of a method for operating a scope is shown.

[0013] Figure 3 A flowchart of an example of a method for operating a scope is shown.

[0014] Figure 4 A flowchart of an example of a method for operating a scope is shown.

[0015] Figure 5 A schematic of an example of a computer-based clinical decision support system configured to provide a distance value based on optical properties related to light from a target site is shown. DETAILED DESCRIPTION

[0016] In a surgical system, an endoscope can be extended distally toward a target site. A sensing fiber extending to a distal portion of the endoscope can include a fiber Bragg grating arranged at a distal portion of the sensing fiber. A sensing controller can direct sensing light distally along the sensing fiber such that at least some of the sensing light is reflected as reflected light from the fiber Bragg grating. The sensing controller can perform an optical frequency domain reflectometry measurement on the reflected light to determine a parameter value, e.g., a pressure value or a temperature value, at the fiber Bragg grating. Processing circuitry can analyze the parameter value to determine that a parameter, e.g., pressure or temperature, at the target site satisfies a particular condition, e.g., is too high. In response, the processing circuitry can generate an alert data signal and / or perform another task, e.g., automatically adjust or reduce a pressure of an insufflation medium, automatically adjust or reduce a flow rate of an irrigation agent, or automatically activate a cooling element or a heating element.

[0017] For purposes of this document, the term“automatically” can mean that a particular action can be activated by processing circuitry. For example, the term“automatically” can mean that a particular action can be taken without receiving an instruction from a user to initiate the particular action. The term“automatically” can include prompting a user for confirmation and obtaining confirmation from the user to proceed with a particular operation. For example, processing circuitry can automatically calculate or automatically determine a new suggested parameter value, and can prompt a user to accept the suggested parameter value or confirm that the suggested parameter value is acceptable.

[0018] Figure 1 A side view schematic of an example of a surgical system 100 is shown. Figure 1 The configuration of FIG. 1 is just one example of a surgical system; other configurations can also be used.

[0019] The surgical system 100 can include an endoscope 102. The endoscope 102 can include an elongate body portion extending between a proximal end 104 and a distal end 106. The precise shape of the elongate body portion can depend on the medical procedure for which the endoscope 102 is initially designed. For simplicity, the elongate body portion is shown as a cylinder and has a circular cross-section taken orthogonal to the direction of elongation. Other suitable shapes can also be used. During use in a procedure, the endoscope 102 can be extended distally toward a target site 110 (e.g., a kidney stone). The endoscope 102 can include one or more light sources or light emitters 108 at the distal end 106 of the endoscope 102 to illuminate the target site 110. Examples of suitable light emitters 108 can include light-emitting diodes such as white light-emitting diodes, arc lamps such as xenon arc lamps, and the like. The endoscope 102 can include one or more cameras or imaging sensors 112 at the distal end 106 of the endoscope 102 to capture images of the illuminated target site 110, such as real-time video images. The endoscope 102 can include one or more heating elements 114 such as resistive heaters that can controllably heat the target site 110 or one or more other suitable regions on the endoscope 102. The endoscope 102 can include one or more cooling elements 116 such as thermoelectric coolers that can controllably cool the target site 110 or one or more other suitable regions on the endoscope 102. The endoscope 102 can provide an insufflation medium such as helium or carbon dioxide to the target site 110 via an insufflation medium port 120 to temporarily inflate the target site 110 during a procedure. The endoscope 102 can provide an irrigant such as saline to the target site 110 via an irrigant port 122 to help cool or remove particulates that can be generated during a procedure, such as kidney stone fragments.

[0020] The endoscope 102 can include various electrical connections that extend along the length of the endoscope, such as to power the one or more light emitters 108, to carry data signals from the one or more imaging sensors 112, to power the one or more heating elements 114, to power the one or more cooling elements 116, and the like. Although Figure 1 The electrical connections in the endoscope 102 are shown as each extending proximally to a respective location at the proximal end 104 of the endoscope 102, in practice, the electrical connections can be grouped together so that they can be made with a single connector at or near the proximal end 104 of the endoscope 102. For example, in practice, the electrical connections can extend along a single channel within the endoscope 102 and can fan out as needed at or near the distal end 106 of the endoscope 102.

[0021] The endoscope 102 can provide a therapeutic laser to the target site 110. The surgical system 100 can include at least one treatment fiber 118 to deliver the therapeutic laser. The at least one treatment fiber 118 can be positioned to extend from the distal end 106 of the endoscope 102. The treatment fiber 118 can be configured to emit treatment fiber light toward the target site 110, for example, directed onto a kidney stone to perform lithotripsy and / or fragmentation of the kidney stone. The surgical system 100 can include a treatment laser source 128, which can generate the therapeutic laser, direct the therapeutic laser into a proximal portion of the treatment fiber 118, and direct the therapeutic laser distally along a length of the treatment fiber 118 to be emitted from a distal end of the treatment fiber 118 to form the treatment fiber light. The treatment laser source 128 can include a thulium fiber laser, which can produce light at a wavelength of 1908 nm and / or 1940 nm. The treatment laser source 128 can include a thulium:YAG (yttrium aluminum garnet) laser, which can produce light at a wavelength of 2010 nm. The treatment laser source 128 can include a holmium:YAG laser, which can produce light at a wavelength of 2120 nm. The treatment laser source 128 can include an erbium:YAG laser, which can produce light at a wavelength of 2940 nm. For these (and other) treatment laser sources, the treatment laser has one or more wavelengths in a portion of the electromagnetic spectrum in which water, a primary component of tissue, has a relatively high absorbance. During a procedure, tissue can absorb the treatment laser, can heat locally to a relatively high temperature, and can break due to local thermal strain within the tissue.

[0022] The surgical system 100 can include a sensing fiber 124, which can extend to a distal portion of the endoscope 102. The sensing fiber 124 can include a fiber Bragg grating 126 disposed at a distal portion of the sensing fiber.

[0023] The sensing fiber 124 can include more than one fiber Bragg grating 126 along a length of the sensing fiber 124. For example, the sensing fiber 124 can include a first fiber Bragg grating 126A and a second fiber Bragg grating 126B located proximally of the first fiber Bragg grating 126A. Using multiple fiber Bragg gratings 126 along the sensing fiber 124 can allow the surgical system to determine one or more physical conditions at the locations of the fiber Bragg gratings 126. For example, the sensing fiber 124 can be routed in the endoscope 102 to have the first fiber Bragg grating 126A at or near the distal end 106 of the endoscope 102 to determine physical conditions at or near the target site 110 and the second fiber Bragg grating 126B to determine physical conditions at or near a component of the endoscope 102 (e.g., a handle). Other locations can also be used.

[0024] Alternatively or additionally, using a plurality of fiber Bragg gratings 126 along the sensing fiber 124 can allow the surgical system 100 to compare physical conditions at two different locations. For example, the surgical system 100 can use measurements of pressure or fluid pressure obtained at two different locations along a fluid channel to determine whether the fluid channel is blocked.

[0025] The surgical system 100 may include a sensing controller 130 coupled to a sensing fiber 124. The sensing controller 130 may guide sensing light distally along the sensing fiber 124 such that at least some of the sensing light is reflected as reflected light from fiber Bragg gratings 126. The sensing controller 130 may perform an optical frequency domain reflectance measurement on the reflected light. The sensing controller 130 may determine parameter values ​​at the fiber Bragg gratings 126 based on the optical frequency domain reflectance measurement. Suitable parameter values ​​may include pressure values, temperature values, etc. For a sensing fiber 124 comprising multiple fiber Bragg gratings 126, the sensing controller 130 may determine parameter values ​​at some or all of the locations of the fiber Bragg gratings 126, and may do so substantially simultaneously via optical frequency domain reflectance measurement. The sensing controller 130 may use optical frequency domain reflectance measurement (OFDR) with the sensing fiber 124 to determine temperature and / or (fluid) pressure values ​​at the location of the fiber Bragg grating 126 or at one or more fiber Bragg gratings 126 arranged along the sensing fiber 124. The sensing controller 130 may include a variable-frequency laser beam coupled to the optical interferometer. The sensing controller 130 may split the light from the variable-frequency laser beam between the reference arm and the measurement arm of the interferometer. In the optical path of the measurement arm, the sensing controller 130 may also split the light beam to propagate distally along the length of the sensing fiber 124, which includes a fiber Bragg grating 126, and proximally along the sensing fiber 124. The light in the measurement arm interferes with the light in the reference arm to form an interference pattern. The sensing controller 130 may include an optical detector capable of detecting the interference pattern. Other suitable configurations may also be used to determine the temperature and / or pressure at one or more fiber Bragg gratings 126 arranged along the sensing fiber 124.

[0026] For example, a polarization maintaining optical fiber can have a cross-section that includes a core located at its center and two holes located on opposite sides of the core. The holes can define two hollow (or gas-filled) channels that extend along the length of the optical fiber on opposite sides of the core. The holes can optionally be circular in cross-section. The holes induce birefringence in the optical fiber such that a cross-sectional axis that extends through the center of the hole can define a slow axis, and a cross-sectional axis that extends between the holes (e.g., with the holes on opposite sides of the axis) can define a fast axis. The core can optionally have a cross-section that is elongated along the fast axis. In a polarization maintaining optical fiber, light that is launched into the optical fiber with linear polarization aligned with the fast axis can be emitted from the optical fiber with linear polarization aligned with the fast axis. Likewise, light that is launched into the optical fiber with linear polarization aligned with the slow axis can be emitted from the optical fiber with linear polarization aligned with the slow axis.

[0027] In addition to providing birefringence in the optical fiber, the holes can provide relatively high sensitivity to pressure along the fast axis and relatively low sensitivity to pressure along the slow axis. For example, changes in pressure can shift the wavelength reflected by the fiber Bragg grating 126: a relatively small wavelength shift for the slow axis and a relatively large wavelength shift for the fast axis.

[0028] In contrast to pressure, the sensitivity to temperature can be the same along the slow and fast axes. For example, changes in temperature values can shift the wavelength reflected by the fiber Bragg grating 126: the same wavelength shift for both the slow and fast axes.

[0029] Because polarization maintaining fiber (with a hole running through it) exhibits a difference in direction dependence for pressure sensitivity but not for temperature sensitivity, polarization maintaining fiber (with a hole running through it) can allow surgical system 100 to separate the effects of temperature from the effects of pressure, resulting in more accurate temperature and pressure values. Specifically, sensing controller 130 can direct first sensing light that is linearly polarized along a slow axis of sensing fiber 124 distally along sensing fiber 124, and second sensing light that is linearly polarized along a fast axis of sensing fiber 124 distally along sensing fiber 124. Sensing controller 130 can take two measurements of pressure, one for the first sensing light and the other for the second sensing light. Sensing controller 130 can use the difference between the two pressure measurements, optionally one or both of the pressure measurements, and optionally one or both of the temperature measurements, to accurately determine a pressure value at fiber Bragg grating 126. In other words, detecting changes in the wavelength difference between the fast and slow axis signals of the reflection can allow surgical system 100 to detect and measure changes in pressure at the fiber Bragg grating, and do so independent of changes in temperature and strain at the fiber Bragg grating. Surgical system 100 can use OFDR techniques described herein to perform pressure and temperature measurements, and can optionally take a set of measurements for the fast axis and another set of measurements for the slow axis to more accurately determine pressure and / or temperature.

[0030] Surgical system 100 can include processing circuitry 132 coupled to sensing controller 130. Processing circuitry 132 can be referred to as a controller. Processing circuitry 132 can be implemented in pure software. Processing circuitry 132 can be implemented in pure hardware. In some examples, processing circuitry 132 can be implemented as a combination of software and hardware. Processing circuitry 132 can be implemented on a single processor. Processing circuitry 132 can be implemented on multiple processors. The multiple processors can be housed in a common housing (e.g., housing 134). In some examples, at least two of the multiple processors can be spaced apart in different housings. Housing 134 can house one or more of processing circuitry 132, sensing controller 130, or treatment laser source 128. Processing circuitry 132 can include one or more processors, memory containing instructions executable by the one or more processors to cause the one or more processors to perform operations. Examples of such operations are described in detail below.

[0031] The processing circuit 132 can analyze the parameter value. The processing circuit 132 can determine whether the parameter at the target site 110 meets a specified condition based on the analysis of the parameter value. Suitable parameters can include pressure, temperature, and other physical conditions. Suitable specified conditions can include the pressure being too high or too low, a pressure gradient (e.g., obtained from two or more locations along the sensing optical fiber 124) being too high or too low, a rate of change of pressure (e.g., from repeated measurements of pressure over time) being too high or too low, the temperature being too high or too low, a temperature gradient (e.g., obtained from two or more locations along the sensing optical fiber 124) being too high or too low, a rate of change of temperature (e.g., from repeated measurements of temperature over time) being too high or too low, and the like. Determining that the parameter value is too high can include determining that the parameter value is greater than a specified threshold. Determining that the parameter value is too low (or too high) can include determining that the parameter value is less than (or greater than) a specified threshold. Other criteria can also be used.

[0032] The processing circuit 132 can take one or more actions in response to a determination that the parameter at the target site 110 (or other location along the sensing optical fiber 124) meets a specified condition.

[0033] Examples of suitable actions can include generating an alert data signal 136, e.g., alerting a user, device, or process. The alert data signal 136 can alert a user that the pressure at the target site 110 can be too high. The alert data signal 136 can alert a user that the pressure at the target site 110 can be changing too quickly. The alert data signal 136 can alert a user that the insufflation medium channel can be blocked. The alert data signal 136 can alert a user to adjust the pressure of the insufflation medium. The alert data signal 136 can alert a user that the temperature at the target site 110 can be too high. The alert data signal 136 can alert a user that the temperature at the target site 110 can be changing too quickly. The alert data signal 136 can alert that the temperature at the target site 110 can be changing too quickly. The alert data signal 136 can alert that a component of the endoscope 102 can be too hot and can indicate to take one or more actions to avoid damage to the component. Other suitable alert data signals can also be used. The alert can be provided visually, e.g., via one or more indicator lights 138 or indicator signs on the endoscope 102 or on a graphical user display 140 coupled to the endoscope 102 or the processing circuit 132. Alternatively or additionally, the alert can be provided aurally, e.g., by a speaker on or in the endoscope 102 or on a graphical user display 140 coupled to the endoscope 102 or the processing circuit 132.

[0034] Other suitable actions can include automatically adjusting the pressure of the insufflation medium, automatically decreasing the flow rate of the irrigant, automatically increasing the flow rate of the irrigant, automatically decreasing the power of the treatment laser, automatically activating one or more cooling elements 116, automatically activating a plurality of heating elements 114, and the like.

[0035] More specific examples of parameters and parameter values, specified conditions, and appropriate actions are described below.

[0036] In a first example, where the parameter is pressure and the parameter value is a pressure value, the processing circuit 132 can cause the endoscope 102 to provide an alert to the user, device, or process to adjust the pressure of the insufflation medium in response to a determination that the pressure at the target site 110 satisfies the specified condition. The processing circuit 132 can cause the endoscope 102 to automatically adjust the pressure of the insufflation medium in response to a determination that the pressure at the target site 110 satisfies the specified condition.

[0037] In a second example, where the parameter is pressure and the parameter value is a pressure value, the processing circuit 132 can analyze the pressure value by comparing the pressure value to a threshold pressure value. The specified condition can be that the pressure value exceeds the threshold pressure value. The alert data signal 136 can alert the user, device, or process that the pressure at the target site 110 can be too high.

[0038] In a third example, where the parameter is pressure and the parameter value is a pressure value, the processing circuit 132 can automatically decrease the flow rate of the irrigant in response to a determination that the pressure value exceeds a threshold pressure value.

[0039] In a fourth example, where the parameter is pressure and the parameter value is a pressure value, the processing circuit 132 can analyze the pressure value by comparing a rate of change of the pressure value to a specified criterion or condition (e.g., to a threshold pressure slope value). The specified condition can be that the rate of change of the pressure value exceeds the threshold pressure slope value. The alert data signal 136 can alert the user, device, or process that the pressure at the target site 110 can be changing too quickly.

[0040] In a fifth example, the sensing fiber 124 can include more than one fiber Bragg grating 126. The parameter can be pressure, for example. The fiber Bragg grating 126 can be a first fiber Bragg grating 126A. The sensing fiber 124 can include a second fiber Bragg grating 126B located proximal to the first fiber Bragg grating 126A. The sensing controller 130 can determine a first pressure value at the first fiber Bragg grating 126A and a second pressure value at the second fiber Bragg grating 126B from an optical frequency domain reflectometry measurement. The processing circuit 132 can analyze the first pressure value and the second pressure value by comparing a difference between the first pressure value and the second pressure value to a specified criterion (e.g., a threshold pressure difference). The processing circuit 132 can determine, from the analysis of the first pressure value and the second pressure value, that the pressure at the target site 110 exceeds the threshold pressure difference. The alarm data signal 136 can alert a user, device, or process that the insufflation medium channel can be obstructed.

[0041] In a sixth example, where the parameter is temperature and the parameter value is a temperature value, the processing circuit 132 can analyze the temperature value by comparing the temperature value to a specified condition, such as a threshold temperature value. The specified condition can be that the temperature value exceeds the threshold temperature value. The alarm data signal 136 can alert a user, device, or process that the temperature at the target site 110 can be too high.

[0042] In a seventh example, where the parameter is temperature and the parameter value is a temperature value, the processing circuit 132 can automatically reduce the power of the treatment laser in response to a determination that the temperature value satisfies a specified condition (e.g., exceeds a threshold temperature value).

[0043] In an eighth example, where the parameter is temperature and the parameter value is a temperature value, the processing circuit 132 can automatically increase the flow rate of the irrigation agent in response to a determination that the temperature value satisfies a specified condition (e.g., exceeds a threshold temperature value).

[0044] In a ninth example, where the parameter is temperature and the parameter value is a temperature value, the processing circuit 132 can automatically activate the cooling element 116 in response to a determination that the temperature value satisfies a specified condition (e.g., exceeds a threshold temperature value).

[0045] In a tenth example, where the parameter is temperature and the parameter value is a temperature value, the processing circuit 132 can analyze the temperature value by comparing the temperature value to a specified criterion (e.g., a threshold temperature value). The specified condition can be that the temperature value is below the threshold temperature value. The processing circuit 132 can automatically activate the heating element 114 in response to a determination that the temperature value is below the threshold temperature value.

[0046] In an eleventh example, where the parameter is temperature and the parameter value is a temperature value, the processing circuit 132 can analyze the temperature value by comparing a rate of change of the temperature value to a specified criterion (e.g., a threshold temperature slope value). The specified condition can be that the rate of change of the temperature value exceeds the threshold temperature slope value. The alert data signal 136 can alert a user, device, or process that the temperature of the target site 110 can be changing too quickly.

[0047] In a twelfth example, the sensing optical fiber 124 can include more than one fiber Bragg grating 126. For example, the fiber Bragg grating can be a first fiber Bragg grating 126A. The sensing optical fiber 124 can include a second fiber Bragg grating 126B located proximal to the first fiber Bragg grating 126A. The sensing controller 130 can determine a first temperature value at the first fiber Bragg grating and a second temperature value at the second fiber Bragg grating from an optical frequency domain reflectometry measurement. The processing circuit 132 can analyze the first temperature value and the second temperature value. The processing circuit 132 can determine from the analysis of the second temperature value that a temperature at a component of the endoscope 102 satisfies a specified condition. For example, the temperature at the component can exceed a specified threshold temperature for the component. As a specific example, the alert data signal 136 can alert a user, device, or process that the temperature at the component can be too hot and can indicate that one or more actions be taken to avoid damage to the component.

[0048] The twelve specific examples of parameters and parameter values, specified conditions, and suitable actions are merely examples. Other suitable combinations of parameters and parameter values, specified conditions, and suitable actions can also be used.

[0049] Figure 2 A flowchart showing an example of a method 200 for operating a surgical system (e.g., the surgical system 100 ( Figure 1 )) is shown. In the surgical system, an endoscope (e.g., the endoscope 102) can be extended distally toward a target site (e.g., the target site 110). A sensing optical fiber (e.g., the sensing optical fiber 124) can extend to a distal end portion of the endoscope and can include a fiber Bragg grating, such as the fiber Bragg grating 126, disposed at a distal end portion of the sensing optical fiber. The method 200 can be performed by the surgical system 100 or by another suitable surgical system. For example, the method 200 can be performed by a monopolar or bipolar radiofrequency device, an ultrasonic lithotripsy device, an ultrasonic device for tissue modification, a combined energy device, a cold plasma type device, a diagnostic device (e.g., a needle aspirator, where the device uses insufflation to create an improved view of the target site), a diagnostic device that uses cryogenic or radiofrequency energy to capture a sample, etc. The method 200 is merely one method for operating a surgical system; other suitable methods can also be used.

[0050] At operation 202, a sensing controller (e.g., sensing controller 130) can direct sensing light along a sensing optical fiber distally such that at least some of the sensing light is reflected as reflected light from a fiber Bragg grating.

[0051] At operation 204, the sensing controller can perform an optical frequency domain reflectometry (OFDR) on the reflected light.

[0052] At operation 206, the sensing controller can determine, from the optical frequency domain reflectometry, a parameter value at the fiber Bragg grating.

[0053] At operation 208, processing circuitry (e.g., processing circuitry 132) can analyze the parameter value.

[0054] At operation 210, the processing circuitry can determine, from the analysis of the parameter value, that a parameter at the target site satisfies a specified condition.

[0055] At operation 212, the processing circuitry can generate an alert data signal, e.g., alert data signal 136, in response to the determination that the parameter at the target site satisfies the specified condition.

[0056] Figure 3 A flowchart showing an example of a method 300 for operating a surgical system (e.g., surgical system 100 ( Figure 1 ) is shown. In the surgical system, an endoscope (e.g., endoscope 102) can extend distally toward a target site (e.g., target site 110) and provide insufflation media to the target site. A sensing optical fiber (e.g., sensing optical fiber 124) can extend to a distal end portion of the endoscope and can include a fiber Bragg grating, e.g., fiber Bragg grating 126, disposed at a distal end portion of the sensing optical fiber. Method 300 can be performed by surgical system 100 or another suitable surgical system. Method 300 is just one method for operating a surgical system; other suitable methods can also be used.

[0057] At operation 302, a sensing controller (e.g., sensing controller 130) can direct sensing light along a sensing optical fiber distally such that at least some of the sensing light is reflected as reflected light from a fiber Bragg grating.

[0058] At operation 304, the sensing controller can perform an optical frequency domain reflectometry (OFDR) on the reflected light.

[0059] At operation 306, the sensing controller can determine, from the optical frequency domain reflectometry, a pressure value at the fiber Bragg grating.

[0060] At operation 308, processing circuitry (e.g., processing circuitry 132) can compare the pressure value to a specified criterion (e.g., a threshold pressure value).

[0061] At operation 310, the processing circuit can determine from this comparison whether the pressure value exceeds the threshold pressure value.

[0062] At operation 312, the processing circuit may, in response to determination that the pressure value exceeds a threshold pressure value, cause the endoscope to perform at least one of operations 314 or 316.

[0063] At operation 314, the endoscope can provide an alarm to the user, device, or process to reduce the pressure of the blown-in medium.

[0064] At point 316, the endoscope can automatically reduce the pressure of the blown-in medium.

[0065] The endoscope can also deliver irrigation fluid to the target area. The processing circuitry can automatically reduce the flow rate of the irrigation fluid in response to the determination that the pressure value exceeds a threshold pressure value.

[0066] Figure 4 A surgical system (e.g., surgical system 100) is shown for operating the surgical system. Figure 1 The flowchart illustrates an example of method 400. In the surgical system, an endoscope (e.g., endoscope 102) may extend distally toward a target site (e.g., target site 110). The endoscope may deliver a therapeutic laser to the target site. The endoscope may deliver an irrigation fluid to the target site. The endoscope may include a cooling element that can controllably cool the target site. A sensing fiber (e.g., sensing fiber 124) may extend to a distal portion of the endoscope and may include a fiber Bragg grating, such as fiber Bragg grating 126, disposed at the distal portion of the sensing fiber. Method 400 may be performed by surgical system 100 or another suitable surgical system. Method 400 is merely one method for operating a surgical system; other suitable methods may also be used.

[0067] At operation 402, the sensing controller (e.g., sensing controller 130) can guide the sensing light along the sensing fiber to the distal side, such that at least some of the sensing light is reflected as reflected light from the fiber Bragg grating.

[0068] At operation 404, the sensing controller can perform optical frequency domain reflectance measurement (OFDR) on the reflected light.

[0069] At operation 406, the sensor controller can determine the temperature value at the fiber Bragg grating based on optical frequency domain reflectance measurements.

[0070] At operation 408, the processing circuit (e.g., processing circuit 132) can compare the temperature value with a specified standard (e.g., a threshold temperature value).

[0071] At operation 410, the processing circuitry can determine, from the comparison, that the temperature value exceeds the threshold temperature value.

[0072] At operation 412, the processing circuitry can cause the endoscope to perform at least one of operations 414, 416, 418, or 420 in response to the determination that the temperature value exceeds the threshold temperature value.

[0073] At operation 414, the endoscope can provide an alert to a user, device, or process that the target site temperature can be too high.

[0074] At operation 416, the endoscope can automatically reduce the power of the treatment laser.

[0075] At operation 418, the endoscope can automatically increase the flow rate of the irrigant.

[0076] At operation 420, the endoscope can automatically activate a cooling element.

[0077] Figure 5 A schematic diagram showing an example of a computer-based clinical decision support system (CDSS) 500 configured to determine whether a parameter value (e.g., a pressure value or a temperature value) satisfies a specified condition is shown. In various implementations, the CDSS 500 includes: an input interface 502 through which patient-specific parameter values are provided as input features to an artificial intelligence (AI) model 504; a processor that performs an inference operation in which the parameter values are applied to the AI model to determine whether the parameter values satisfy the specified condition; and a user interface (UI) or output interface 508 through which the determination is communicated to a user, such as a clinician.

[0078] In some implementations, the input interface 502 can be a direct data link between the CDSS 500 and one or more medical devices (e.g., the surgical system 100 or the endoscope 102) that generate at least some of the input features. For example, the input interface 502 can transmit the parameter values directly to the CDSS during a therapeutic and / or diagnostic medical procedure. Additionally or alternatively, the input interface 502 can be a classic user interface that facilitates interaction between a user and the CDSS 500. For example, the input interface 502 can facilitate a user interface through which a user can manually input the parameter values. Additionally or alternatively, the input interface 502 can provide the CDSS 500 with access to an electronic patient record from which one or more input features can be extracted. In either of these cases, the input interface 502 is configured to collect the parameter values associated with a particular patient at or before a time at which the CDSS 500 is used to evaluate a medical condition (e.g., a kidney stone) being treated by the surgical system 100 or the endoscope 102.

[0079] Based on one or more of the above input features, the processor (e.g., processing circuitry 132) performs an inference operation using an AI model to generate a determination. For example, the input interface 502 can transmit the parameter values to an input layer of the AI model, which propagates the input features through the AI model to an output layer. An AI intelligent model can provide a computer system with the ability to perform tasks without explicit programming by making inferences based on patterns found in the data analyzed. The research and construction of AI model exploration algorithms (e.g., machine learning algorithms) that can learn from existing data and make predictions on new data. Such algorithms operate by building an AI model from example training data in order to make data-driven predictions or decisions that are represented as output or evaluation.

[0080] There are two common modes for machine learning (ML): supervised ML and unsupervised ML. Supervised ML uses prior knowledge (e.g., examples that relate inputs to outputs or outcomes) to learn the relationship between inputs and outputs. The goal of supervised ML is to learn a function that, given some training data, most closely approximates the relationship between the training inputs and outputs so that the ML model can implement the same relationship to generate a corresponding output when given an input. Unsupervised ML is the training of a ML algorithm that uses information that is neither classified nor labeled and allows the algorithm to take action on that information without guidance. Unsupervised ML is useful in exploratory analysis because it can automatically identify structures in the data.

[0081] Common tasks for supervised ML are classification problems and regression problems. Classification problems, also known as categorization problems, aim to classify items into one of several categorical values (e.g., is this object an apple or an orange?). Regression algorithms aim to quantify some items (e.g., by providing a score for some input’s value). Some examples of commonly used supervised ML algorithms are logistic regression (LR), Naive Bayes, random forest (RF), neural networks (NN), deep neural networks (DNN), matrix factorization, and support vector machines (SVM).

[0082] Some common tasks for unsupervised ML include clustering, representation learning, and density estimation. Some examples of commonly used unsupervised ML algorithms are K-means clustering, principal component analysis, and autoencoders.

[0083] Another type of ML is federated learning (also known as collaborative learning), which trains an algorithm across multiple decentralized devices that hold local data without exchanging the data. This approach contrasts with traditional centralized machine learning techniques, in which all local datasets are uploaded to a server, and more classic decentralized approaches, which typically assume that local data samples are identically distributed. Federated learning enables multiple participants to build a common, robust machine learning model without sharing data, allowing for the resolution of key issues such as data privacy, data security, data access permissions, and heterogeneous data access.

[0084] The AI model can be trained continuously or periodically before inference operations are performed by the processor (e.g., processing circuitry 132). Then, during inference operations, patient-specific input features provided to the AI model can propagate from an input layer, through one or more hidden layers, and ultimately to an output layer corresponding to a value of distance (Z).

[0085] The AI model can include a database, which can include data corresponding to patients. The database can provide patient records to the CDSS 500. The AI model can receive parameter values from sensors.

[0086] During and / or after inference operations, the value of distance (Z) can be communicated to a user via a user interface (UI) and / or automatically cause an actuator or alarm connected to the processor to perform a desired action. For example, the processor can cause the actuator to move the optical fiber relative to the endoscope. Alternatively, the processor can trigger an alarm to alert the physician.

[0087] The CDSS 500 can optionally be used to determine an action to take in response to the value of distance (Z).

[0088] In the foregoing detailed description, the methods and apparatus of the present disclosure have been described with reference to specific embodiments thereof. It will, however, be evident that various modifications and changes can be made thereto without departing from the broader spirit and scope of the disclosure. The specification and drawings are, accordingly, to be regarded in an illustrative rather than a restrictive sense.

[0089] To further illustrate the devices and related methods disclosed herein, a non-limiting list of examples is provided below. Each of the following non-limiting examples can exist independently, or can be combined in any permutation or combination with any one or more of the other examples.

[0090] In Example 1, a surgical system can include: a scope configured to extend distally toward a target site; a sensing optical fiber extending to a distal portion of the scope and including a fiber Bragg grating arranged at a distal end portion of the sensing optical fiber; a sensing controller configured to: direct sensing light distally along the sensing optical fiber such that at least some of the sensing light is reflected as reflected light from the fiber Bragg grating; perform an optical frequency domain reflectometry on the reflected light; and determine a parameter value at the fiber Bragg grating from the optical frequency domain reflectometry; and a processing circuit configured to: analyze the parameter value; determine, from the analysis of the parameter value, that a parameter at the target site satisfies a specified condition; and generate an alert data signal in response to the determination that the parameter at the target site satisfies the specified condition.

[0091] In Example 2, the surgical system of Example 1 can optionally be configured such that: the parameter is a pressure; and the parameter value is a pressure value.

[0092] In Example 3, the surgical system of any of Examples 1-2 can optionally be configured such that: the scope is further configured to provide an insufflation medium to the target site; and the processing circuit is further configured to cause the scope to perform at least one of: provide an alert to a user to adjust a pressure of the insufflation medium; or automatically adjust the pressure of the insufflation medium, in response to the determination that the pressure at the target site satisfies the specified condition.

[0093] In Example 4, the surgical system of any of Examples 1-3 can optionally be configured such that: the processing circuit is configured to analyze the pressure value by comparing the pressure value to a threshold pressure value; and the specified condition is that the pressure value exceeds the threshold pressure value.

[0094] In Example 5, the surgical system of any of Examples 1-4 can optionally be configured such that: the alert data signal is configured to alert a user that the pressure at the target site can be too high.

[0095] In Example 6, the surgical system of any of Examples 1-5 can optionally be configured such that: the scope is further configured to provide an irrigation agent to the target site; and the processing circuit is further configured to automatically decrease a flow rate of the irrigation agent in response to the determination that the pressure value exceeds the threshold pressure value.

[0096] In Example 7, the surgical system of any of Examples 1-6 can optionally be configured such that: the processing circuit is configured to analyze the pressure value by comparing a rate of change of the pressure value to a threshold pressure slope value; the specified condition is that the rate of change of the pressure value exceeds the threshold pressure slope value; and the alert data signal is configured to alert a user that the pressure at the target site can be changing too quickly.

[0097] In Example 8, the surgical system of any of Examples 1 to 7 can optionally be configured such that: the parameter is pressure; the fiber Bragg grating is a first fiber Bragg grating; the sensing fiber includes a second fiber Bragg grating located proximal to the first fiber Bragg grating; the sensing controller is further configured to determine, from the optical frequency domain reflectometry, a first pressure value at the first fiber Bragg grating and a second pressure value at the second fiber Bragg grating; the processing circuitry is further configured to: analyze the first pressure and the second pressure by comparing a difference between the first pressure value and the second pressure value to a threshold pressure difference; and determine, from the analysis of the first pressure value and the second pressure value, that the pressure at the target site exceeds the threshold pressure difference; and the alarm data signal is configured to alert the user that the insufflation medium channel can be obstructed.

[0098] In Example 9, the surgical system of any of Examples 1 to 8 can optionally be configured such that: the parameter is temperature; and the parameter value is a temperature value.

[0099] In Example 10, the surgical system of any of Examples 1 to 9 can optionally be configured such that: the processing circuitry is configured to analyze the temperature value by comparing the temperature value to a threshold temperature value; and the specified condition is that the temperature value exceeds the threshold temperature value.

[0100] In Example 11, the surgical system of any of Examples 1 to 10 can optionally be configured such that: the alarm data signal is configured to alert the user that the temperature at the target site can be too high.

[0101] In Example 12, the surgical system of any of Examples 1 to 11 can optionally be configured such that: the endoscope is further configured to provide a therapeutic laser to the target site; and the processing circuitry is further configured to automatically reduce a power of the therapeutic laser in response to the determination that the temperature value exceeds the threshold temperature value.

[0102] In Example 13, the surgical system of any of Examples 1 to 12 can optionally be configured such that: the endoscope is further configured to provide an irrigation agent to the target site; and the processing circuitry is further configured to automatically increase a flow rate of the irrigation agent in response to the determination that the temperature value exceeds the threshold temperature value.

[0103] In Example 14, the surgical system of any of Examples 1 to 13 can optionally be configured such that: the endoscope includes a cooling element configured to controllably cool the target site; and the processing circuitry is further configured to automatically activate the cooling element in response to the determination that the temperature value exceeds the threshold temperature value.

[0104] In Example 15, the surgical system of any of Examples 1 to 14 can optionally be configured such that: the processing circuit is configured to analyze the temperature value by comparing the temperature value to a threshold temperature value; the specified condition is that the temperature value is below the threshold temperature value; the endoscope includes a heating element configured to controllably heat the target site; and the processing circuit is further configured to automatically activate the heating element in response to a determination that the temperature value is below the threshold temperature value.

[0105] In Example 16, the surgical system of any of Examples 1 to 15 can optionally be configured such that: the processing circuit is configured to analyze the temperature value by comparing a rate of change of the temperature value to a threshold temperature slope value; the specified condition is that the rate of change of the temperature value exceeds the threshold temperature slope value; and the alert data signal is configured to alert a user that the temperature at the target site can be changing too quickly.

[0106] In Example 17, the surgical system of any of Examples 1 to 16 can optionally be configured such that: the fiber Bragg grating is a first fiber Bragg grating; the sensing fiber includes a second fiber Bragg grating located proximal to the first fiber Bragg grating; the sensing controller is further configured to determine, from the optical frequency domain reflectometry, a first temperature value at the first fiber Bragg grating and a second temperature value at the second fiber Bragg grating; and the processing circuit is further configured to: analyze the first temperature value and the second temperature value; and determine, from the analysis of the second temperature value, that the temperature at the component of the endoscope satisfies the specified condition.

[0107] In Example 18, a surgical system can include: an endoscope configured to extend distally toward a target site and to provide an insufflation medium to the target site; a sensing fiber extending to a distal end portion of the endoscope and including a fiber Bragg grating disposed at a distal end portion of the sensing fiber; a sensing controller configured to: direct sensing light distally along the sensing fiber such that at least some of the sensing light is reflected as reflected light from the fiber Bragg grating; perform optical frequency domain reflectometry on the reflected light; and determine, from the optical frequency domain reflectometry, a pressure value at the fiber Bragg grating; and a processing circuit configured to: compare the pressure value to a threshold pressure value; determine, from the comparison, that the pressure value exceeds the threshold pressure value; and in response to the determination that the pressure value exceeds the threshold pressure value, cause the endoscope to perform at least one of: provide an alert to a user to reduce a pressure of the insufflation medium; or automatically reduce the pressure of the insufflation medium.

[0108] In Example 19, the surgical system of Example 18 can optionally be configured such that: the endoscope is further configured to provide an irrigation agent to the target site; and the processing circuit is further configured to automatically reduce a flow rate of the irrigation agent in response to the determination that the pressure value exceeds the threshold pressure value.

[0109] In Example 20, a surgical system can comprise: a scope configured to extend distally toward a target site, to provide a therapeutic laser to the target site, and to supply an irrigant to the target site, the scope including a cooling element configured to controllably cool the target site; a sensing optical fiber extending to a distal end portion of the scope and including a fiber Bragg grating arranged at a distal end portion of the sensing optical fiber; a sensing controller configured to: direct sensing light distally along the sensing optical fiber such that at least some of the sensing light is reflected as reflected light from the fiber Bragg grating; perform an optical frequency domain reflectometry measurement on the reflected light; and determine a temperature value at the fiber Bragg grating from the optical frequency domain reflectometry measurement; and a processing circuit configured to: compare the temperature value to a threshold temperature value; determine, from the comparison, that the temperature value exceeds the threshold temperature value; and in response to the determination that the temperature value exceeds the threshold temperature value, cause the scope to perform at least one of: provide an alert to a user that a temperature of the target site can be too high; automatically reduce a power of the therapeutic laser; automatically increase a flow rate of the irrigant; or automatically activate the cooling element.

Claims

1. A surgical system comprising: an endoscope configured to extend distally toward a target site; a sensing optical fiber extending to a distal end portion of the endoscope and including a fiber Bragg grating disposed at a distal end portion of the sensing optical fiber; a sensing controller configured to: direct sensing light distally along the sensing optical fiber such that at least some of the sensing light is reflected as reflected light from the fiber Bragg grating; perform an optical frequency domain reflectometry measurement on the reflected light; and determine, from the optical frequency domain reflectometry measurement, a parameter value at the fiber Bragg grating; and processing circuitry configured to: analyze the parameter value; determine, from the analysis of the parameter value, that a parameter at the target site satisfies a specified condition; and generate, in response to the determination that the parameter at the target site satisfies the specified condition, an alert data signal.

2. The surgical system of claim 1, wherein: the parameter is pressure; and the parameter value is a pressure value.

3. The surgical system of claim 2, wherein: the endoscope is further configured to provide an insufflation medium to the target site; and the processing circuitry is further configured to, in response to the determination that the pressure at the target site satisfies the specified condition, cause the endoscope to perform at least one of: provide an alert to a user to adjust a pressure of the insufflation medium; or automatically adjust the pressure of the insufflation medium.

4. The surgical system of claim 2, wherein: the processing circuitry is configured to analyze the pressure value by comparing the pressure value to a threshold pressure value; and the specified condition is that the pressure value exceeds the threshold pressure value.

5. The surgical system of claim 4, wherein: the alert data signal is configured to alert a user that the pressure at the target site can be too high.

6. The surgical system of claim 4, wherein: the endoscope is further configured to provide an irrigation agent to the target site; and the processing circuitry is further configured to, in response to the determination that the pressure value exceeds the threshold pressure value, automatically decrease a flow rate of the irrigation agent.

7. The surgical system of claim 2, wherein: the processing circuitry is configured to analyze the pressure value by comparing a rate of change of the pressure value to a threshold pressure slope value; the specified condition is that the rate of change of the pressure value exceeds the threshold pressure slope value; and the alert data signal is configured to alert a user that the pressure at the target site can be changing too rapidly.

8. The surgical system of claim 1, wherein: the parameter is pressure; the fiber Bragg grating is a first fiber Bragg grating; the sensing optical fiber includes a second fiber Bragg grating located proximally of the first fiber Bragg grating; the sensing controller is further configured to determine, from the optical frequency domain reflectometry measurement, a first pressure value at the first fiber Bragg grating and a second pressure value at the second fiber Bragg grating; the processing circuitry is further configured to: analyzing the first pressure value and the second pressure value by comparing a difference between the first pressure value and the second pressure value to a threshold pressure difference; and determining, in accordance with the analysis of the first pressure value and the second pressure value, that the pressure at the target site exceeds a threshold pressure difference; and the alarm data signal is configured to alert a user that the insufflation medium channel can be obstructed.

9. The surgical system of claim 1, wherein: the parameter is a temperature; and the parameter value is a temperature value.

10. The surgical system of claim 9, wherein: the processing circuit is configured to analyze the temperature value by comparing the temperature value to a threshold temperature value; and the specified condition is that the temperature value exceeds the threshold temperature value.

11. The surgical system of claim 10, wherein: the alarm data signal is configured to alert a user that the temperature at the target site can be too high.

12. The surgical system of claim 10, wherein: the endoscope is further configured to provide a therapeutic laser to the target site; and the processing circuit is further configured to automatically reduce a power of the therapeutic laser in response to a determination that the temperature value exceeds the threshold temperature value.

13. The surgical system of claim 10, wherein: the endoscope is further configured to provide an irrigation agent to the target site; and the processing circuit is further configured to automatically increase a flow rate of the irrigation agent in response to a determination that the temperature value exceeds the threshold temperature value.

14. The surgical system of claim 10, wherein: the endoscope includes a cooling element configured to controllably cool the target site; and the processing circuit is further configured to automatically activate the cooling element in response to a determination that the temperature value exceeds the threshold temperature value.

15. The surgical system of claim 9, wherein: the processing circuit is configured to analyze the temperature value by comparing the temperature value to a threshold temperature value; the specified condition is that the temperature value is below the threshold temperature value; the endoscope includes a heating element configured to controllably heat the target site; and the processing circuit is further configured to automatically activate the heating element in response to a determination that the temperature value is below the threshold temperature value.

16. The surgical system of claim 9, wherein: the processing circuit is configured to analyze the temperature value by comparing a rate of change of the temperature value to a threshold temperature slope value; the specified condition is that the rate of change of the temperature value exceeds the threshold temperature slope value; and the alarm data signal is configured to alert a user that the temperature at the target site can be changing too rapidly.

17. The surgical system of claim 1, wherein: the fiber Bragg grating is a first fiber Bragg grating; the sensing fiber includes a second fiber Bragg grating located proximal to the first fiber Bragg grating; The sensing controller is further configured to determine, from the optical frequency domain reflectometry, a first temperature value at the first fiber Bragg grating and a second temperature value at the second fiber Bragg grating; and The processing circuitry is further configured to: analyze the first temperature value and the second temperature value; and determine, from the analysis of the second temperature value, that a temperature at a component of the endoscope satisfies a specified condition.

18. A surgical system comprising: an endoscope configured to extend distally toward a target site and to provide an insufflation medium to the target site; a sensing optical fiber extending to a distal end portion of the endoscope and including a fiber Bragg grating disposed at a distal end portion of the sensing optical fiber; a sensing controller configured to: direct sensing light distally along the sensing optical fiber such that at least some of the sensing light is reflected as reflected light from the fiber Bragg grating; perform optical frequency domain reflectometry on the reflected light; and determine, from the optical frequency domain reflectometry, a pressure value at the fiber Bragg grating; and processing circuitry configured to: compare the pressure value to a threshold pressure value; determine, from the comparison, that the pressure value exceeds the threshold pressure value; and in response to the determination that the pressure value exceeds the threshold pressure value, cause the endoscope to perform at least one of: provide an alert to a user to reduce a pressure of the insufflation medium; or automatically reduce the pressure of the insufflation medium.

19. The surgical system of claim 18, wherein: the endoscope is further configured to provide an irrigation agent to the target site; and the processing circuitry is further configured to, in response to the determination that the pressure value exceeds the threshold pressure value, automatically reduce a flow rate of the irrigation agent.

20. A surgical system comprising: an endoscope configured to extend distally toward a target site, to provide a therapeutic laser to the target site, and to provide an irrigation agent to the target site, the endoscope including a cooling element configured to controllably cool the target site; a sensing optical fiber extending to a distal end portion of the endoscope and including a fiber Bragg grating disposed at a distal end portion of the sensing optical fiber; a sensing controller configured to: direct sensing light distally along the sensing optical fiber such that at least some of the sensing light is reflected as reflected light from the fiber Bragg grating; perform optical frequency domain reflectometry on the reflected light; and determine, from the optical frequency domain reflectometry, a temperature value at the fiber Bragg grating; and processing circuitry configured to: compare the temperature value to a threshold temperature value; determine, from the comparison, that the temperature value exceeds the threshold temperature value; and in response to the determination that the temperature value exceeds the threshold temperature value, cause the endoscope to perform at least one of: provide an alert to a user that the temperature at the target site can be too high; automatically reduce a power of the therapeutic laser; ​ automatically increasing the flow rate of the flushing agent; or automatically activating the cooling element.

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