Medical devices, systems, and methods for determining target size

Abstract

A medical system can include a medical device, a processor, and an instrument. The medical device can have a handle and a shaft defining a working channel. The shaft can have a distal opening at a distal end of the shaft. The distal end can include an imager. The instrument can be movable along the working channel to contact a target distal of the distal end of the shaft. The processor can be configured to determine a depth of the target based on pixel characteristics of the target and the instrument in at least one image generated by the imager and based on a proximity of the instrument to the target in the at least one image.

Description

[0001] Cross-references to related applications

[0002] This application claims priority to U.S. Provisional Application No. 63 / 610,455, filed December 15, 2023, which is incorporated herein by reference in its entirety. Technical Field

[0003] This disclosure generally relates to medical devices, systems, and related methods for determining target features within body cavities. In particular, some aspects relate to medical systems, devices, and methods for determining the dimensions of objects within a subject's body. In some aspects, dimensions can be used to generate three-dimensional images of the object. Background Technology

[0004] The method of removing urinary or kidney stones from a patient may depend on the size of the stone. For example, some smaller stones or fragments may be large enough to pass through body cavities, such as the urinary tract, and be expelled from the body. In some cases, larger stones or residual fragments may be broken into smaller pieces before removal, for example, via lithotripsy. Some stones may require follow-up and / or additional intervention, for example at a later time. The size of the object can be a factor to consider when determining the removal method. Size estimation is often inaccurate due to the inherent challenges associated with measuring three-dimensional objects from two-dimensional images, especially when the image resolution or visibility is low. Summary of the Invention

[0005] This disclosure includes medical devices, systems, and related methods for analyzing targets such as kidney stones and / or other objects in the body. For example, this disclosure includes a medical system comprising a medical device, a processor, and an instrument. The medical device may have a handle and an axis defining a working channel. The axis may have a distal opening at its distal end. The distal end may include an imager. The instrument may be movable along the working channel to contact a target distal to the distal end of the axis. The processor may be configured to determine the depth of the target based on pixel characteristics of the target and the instrument in at least one image generated by the imager, and based on the proximity of the instrument to the target in at least one image.

[0006] Any medical system described above and elsewhere herein may include any of the following features: The handle of the medical device may include a processor. The instrument may have a known diameter. The processor may be configured to further determine the depth of the target based on the known diameter of the instrument and the contact between the instrument and the target. The processor may be configured to determine the depth of the target based on a comparison of pixel characteristics of the instrument with pixel characteristics of the target in at least one image. In at least one image, the distal end of the instrument may be adjacent to the target. The instrument may include an optical fiber. The instrument may include a laser fiber configured to fragment the target. At least one image may include multiple images. In each of the multiple images, the target may have a different orientation relative to the instrument.

[0007] The medical system may also include a display. The display may be configured to show the depth of a target determined by the processor in at least one image. The processor may also be configured to perform segmentation on at least one image.

[0008] In some respects, the processor can also be configured to determine the length and / or width of the target based on pixel characteristics of the target and the instrument in at least one image, and based on the proximity of the instrument to the target in at least one image. The processor can be configured to generate a three-dimensional representation of the target. The processor can store the known diameter of the instrument and / or can be configured to prompt the user to input the known diameter of the instrument.

[0009] This disclosure also includes methods for determining the depth of a target using a medical system described above and / or elsewhere herein. The target may be a kidney stone. Uses of the medical system may include generating a three-dimensional image of the target. The processor may determine the depth of the target based on pixel characteristics of the target in multiple images and pixel characteristics of an instrument.

[0010] This disclosure also includes a method for analyzing a target within a subject's body. The method may include introducing an axis of a medical device into a body cavity including the target; positioning a distal end of the axis near the target, the distal end including an imager; extending the instrument through a working channel of the medical device to the position near the target; generating multiple images of the target and the instrument via the imager; and determining the depth of the target via a processor based on pixel characteristics of the target and the instrument in the multiple images.

[0011] In some aspects, extending the instrument to that location may include contacting the target. The method may also include comparing pixel characteristics of the target with pixel characteristics of the instrument. Determining the depth of the target may include calculating the distance between the target and the instrument. The instrument may include an optical fiber. The target may be a kidney stone. The instrument may include a laser fiber. The method may also include fragmenting the target with a laser fiber.

[0012] In various aspects of this disclosure, the method may further include performing segmentation on at least one of a plurality of images via a processor. The method may include positioning a distal end of an axis of a medical device as an approach target, wherein the distal end of the axis includes an imager; extending an instrument through a working channel of the medical device to the approach target location, wherein the instrument includes a laser fiber; generating at least one image of the target and the instrument via the imager; determining pixel characteristics of the target and the instrument in the at least one image via a processor of the medical device; and determining the depth of the target via the processor based on the pixel characteristics of the target and the instrument.

[0013] In various aspects of this disclosure, extending the instrument to the location may include contacting the target. At least one image may include multiple images, and in each image, the target may have a different orientation relative to the instrument. The method may also include rotating the target between generating a first image and generating a second image in a plurality of images. Attached Figure Description

[0014] The accompanying drawings, incorporated in and constituting a part of this application, illustrate exemplary aspects that, together with the written description, serve to explain the principles of this disclosure. Each figure depicts one or more exemplary aspects according to this disclosure, as follows:

[0015] Figure 1A and Figure 1B Exemplary medical systems according to various aspects of this disclosure are described.

[0016] Figure 2 Exemplary images obtained by a medical system according to various aspects of this disclosure are depicted.

[0017] Figure 3 A flowchart illustrating exemplary methods according to various aspects of this disclosure is provided.

[0018] Figure 4A and Figure 4B The objectives of each aspect of this disclosure are shown in the first position ( Figure 4A ) and second position ( Figure 4B An example image.

[0019] Figure 5 A flowchart illustrating exemplary methods according to various aspects of this disclosure is provided. Detailed Implementation

[0020] Reference will now be made in detail to aspects and examples of this disclosure, as illustrated in the accompanying drawings. Where possible, the same reference numerals will be used throughout the drawings to refer to the same or similar parts.

[0021] Aspects of this disclosure are now described with reference to exemplary systems and methods for measuring and estimating one or more dimensions of an object in a body cavity. Reference to medical procedures describes aspects in which a medical device is guided through a body cavity to approach an object, such as within a subject's urinary tract. For example, the medical device may include an shaft that can be introduced into the body cavity, such as a ureter, and advanced through the urethra until the distal end of the shaft is located in a renal calyx, adjacent to one or more kidney stones. One or more dimensions of the kidney stones can be analyzed and determined according to aspects of this disclosure. References to specific types of procedures, body cavities, and objects are provided for illustrative purposes and are not intended to limit this disclosure.

[0022] The foregoing general description and the following detailed description are exemplary and illustrative only and do not limit the claimed features. As used herein, the terms “comprises,” “comprising,” “having,” “including,” or other variations thereof are intended to cover non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements may include not only those elements but also other elements not expressly listed or inherent to such a process, method, or apparatus. In this disclosure, relative terms such as, for example, “about,” “substantially,” “generally,” and “approximately” are used to indicate possible variations of ±10% in the stated values ​​or characteristics.

[0023] In some technologies, medical devices with imagers are used to visualize objects within the body, such as stones, and medical professionals can seek information about the size of the object. According to this disclosure, such information can be obtained, for example, by comparing the object to the known dimensions of the instrument in an image of both the object and the instrument. Measuring or estimating the size of the object (including dimensions such as length, width, and / or depth) can help determine an appropriate object removal procedure. The width, length, and depth of the object can be used for object size estimation. The depth of the object refers to the dimension between the proximal and distal sides of the object. This information can be used, for example, to generate three-dimensional images, representations, reconstructions, or models of the object.

[0024] Now for reference Figure 1A and Figure 1B An exemplary medical system 100 for use in this disclosure is described. System 100 includes a medical device 10 that can be coupled to an apparatus 60. For example, medical device 10 may include a ureteroscope, endoscope, bronchoscope, duodenoscope, colonoscope, etc., and may include a shaft extending distally from a handle. Medical device 10 includes a handle 20 having at least one actuator (e.g., a first actuator 22 and a second actuator 24), a port 28, and a shaft 30 having a maneuverable portion 32 and a distal end 30D.

[0025] Actuators 22 and 24 can receive user input and transmit it to axis 30. Each actuator 22 and 24 may include a lever, knob, slider, joystick, button, or other suitable mechanism. For example, a first actuator 22 may be configured to hinge an operable portion 32, for example, via one or more traction wires within axis 30, and a second actuator 24 may be configured to actuate and / or control other aspects of the medical device 10, such as turning a laser source on / off and / or capturing images.

[0026] According to some aspects of this disclosure, the device 60 can be configured to supply vacuum / suction, fluid (e.g., liquid, air), and / or electricity to the medical device 10 via the umbilical tube 26. Figure 1A As shown, the device 60 may include a processor 62, for example, which may operate in conjunction with the medical device 10. For example, the processor 62 may assist in generating a visual representation of image data and / or transmitting the visual representation to one or more interface devices, such as the display 12. According to some aspects, the processor 62 may enhance the visual representation. The display 12 may include, for example, a touchscreen display or other display capable of displaying images, wherein information about features may optionally be shown in one or more images generated using the medical device 10 and the processor 62.

[0027] Although Figure 1A The processor 62 is part of the apparatus 60 coupled to the medical device 10, but additionally or alternatively, the medical device 10 may include the processor 62. For example, the processor 62 may be included in the handle 20 of the medical device 10.

[0028] Port 28 of handle 20 may include one or more openings communicating with working channel 34 of shaft 30. Instruments such as, for example, fiber optic 90 (e.g., laser fiber), grippers, retrieval devices, etc., can be inserted through port 28 and moved distally through working channel 34 across shaft 30 to exit working channel 34 distal to shaft 30. Shaft 30 may also include one or more cavities for receiving traction wires and / or other wiring, cables, and / or fluid tubing. While the discussion herein generally refers to fiber optic 90 as an exemplary instrument movable along working channel 34 (or along the edge of medical device 10) and used for analysis of targets, it should be understood that this disclosure is not limited to fiber optics. One or more alternative instruments (e.g., guidewires, baskets, snares, forceps, etc.) may be used in place of or as a supplement to fiber optic 90. Therefore, aspects of fiber optic 90 discussed below are applicable to any instrument, e.g., for performing binding Figure 3 The discussion covers one or more aspects of method 200.

[0029] like Figure 1BAs shown, the distal end 30D of the shaft 30 may include a distal opening of the working channel 34, an imager 42 (e.g., a camera or other imaging device), and a light source 46. In some examples, the shaft 30 may include a cap covering a portion of the distal end 30D, for example, protecting features such as the imager 42 and / or the light source 46. In some examples, the imager 42 may include a camera containing a CMOS sensor. In some examples, the imager 42 may include an optical fiber communicating with a sensor or other device within the shaft 30 or the handle 20. In some examples, the light source 46 may include a plastic optical fiber (POF) device or a light-emitting diode (LED). Optionally, the distal end 30D may include a sensor 48, such as a pressure sensor, a distance sensor, a light sensor, a temperature sensor, an ultrasonic sensor, etc.

[0030] Figure 2 An exemplary image 80 is depicted generated via an imager of a medical device according to this disclosure, such as imager 42 of medical device 10. Image 80 may be displayed on display 12. When image 80 is generated via processor 62, the distal end 30D of medical device 10 (and therefore imager 42) may be close to target 150. While target 150 may be various anatomical structures or foreign bodies, in this example, target 150 is depicted as a kidney stone.

[0031] The optical fiber 90 is movable within the working channel 34 of the axis 30. The optical fiber 90 can extend distally through the working channel 34 such that at least a portion of the optical fiber 90 exits the working channel 34 to the distal end 30D of the medical device 10. In some aspects, the optical fiber 90 can be inserted along an edge of the axis 30. In some aspects, at least a portion of the optical fiber 90 may include a sheath 92.

[0032] Fiber 90 may include a laser fiber, such as one capable of fragmenting stones via laser lithotripsy, or may include an optical fiber. Fiber 90 may include a transparent or translucent material that can provide the ability to visualize a portion of the target 150 behind fiber 90 (e.g., otherwise obscured by opaque fiber or sheath 92). In other respects, fiber 90 may include an opaque material.

[0033] Optionally, the optical fiber 90 and / or sheath 92 may include one or more markings 94. The one or more markings 94 may indicate the distance relative to the distal end 30D of the medical device 10. In some examples, the markings 94 may be regularly spaced apart from each other (e.g., the distance between adjacent markings 94 is 1 mm, 1.5 mm, 2 mm, etc.). For example, one or more markings 94 and / or other features of the optical fiber 90 may be used to roughly estimate the length of the optical fiber 90 extending distally from the distal end 30D of the medical device 10.

[0034] The dimensions of the optical fiber 90, such as its diameter and length, are known and can be used to determine the dimensions of the target 150, for example, by the proximity of the optical fiber 90 to the target 150 and by comparing the pixel characteristics of the optical fiber 90 and the target 150 in the image 80. For example, the diameter of the optical fiber 90 may be known and stored by the processor 62. In some aspects, the diameter may be manually entered into the medical system 100 by the user (e.g., using a keyboard or other input device) and stored by the processor 62. In some aspects, the diameter of the optical fiber 90 may be pre-programmed into the processor 62.

[0035] Additionally or alternatively, the diameter of the optical fiber 90 can be automatically input into the medical system 100 and stored in the processor 62. For example, a machine-readable image (e.g., a barcode or quick-response code) associated with the optical fiber 90 can be scanned via a scanning device, camera, or other reading device. Information associated with the machine-readable image can be transmitted and stored by the processor 62 and / or other aspects of the medical system 100. For example, the machine-readable image associated with the optical fiber 90 may include information such as the diameter of the optical fiber 90, the length of the optical fiber 90, the type of the optical fiber 90 (e.g., laser operating parameters if the optical fiber 90 is a laser fiber), and / or other characteristics of the optical fiber 90, which can be automatically input into the processor 62 after scanning. In these respects, the processor 62 and / or other aspects of the medical system 100 can be configured to decode the machine-readable image associated with the optical fiber 90 and / or retrieve information remotely stored (e.g., on a server) via links or other pointers provided by the machine-readable image.

[0036] Processor 62 (or other aspects of medical system 100) may be configured to use one or more images, such as image 80, to determine one or more dimensions of a target. For example, processor 62 may be configured to determine (e.g., estimate) the size of target 150, such as the length and / or depth of target 150. In some aspects, processor 62 may be configured to perform segmentation. Segmentation, also known as contouring or annotation, is an image processing technique used to delineate regions in an image. For example, segmentation may be performed on image 80 to delineate the outer edges of target 150 (e.g., target segmentation) and / or the outer edges of fiber optic cable 90 (e.g., instrument segmentation). Segmentation may include feature detection and / or feature extraction. For example, features of target 150 may be identified via processor 62. The identified features may be matched between subsequent images. Optionally, medical system 100 may generate three-dimensional images, for example, via processor 62.

[0037] Given the outer edge of the fiber optic cable 90 / sheath 92 and the target 150, as well as the distance from the target 150 to the distal end 30D, the processor 62 can be configured to calculate the number of pixels associated with each of the fiber optic cable 90 / sheath 92 and the target 150. The number of pixels associated with the target 150 can then be used to calculate one or more dimensions of the target 150 (e.g., width and / or height). For example, since the diameter of the fiber optic cable 90 is known, a relationship between the pixel count and one or more dimensions of the target 150 can be provided.

[0038] In some respects, the distal end of the optical fiber 90 may have a known diameter of approximately 1.0 mm. The number of pixels in the image 80 displaying the optical fiber 90 can vary depending on the distance the optical fiber 90 extends distally from the distal end 30D of the medical device 10. As the optical fiber 90 extends distally from the distal end 30D of the medical device 10, fewer pixels can be used to display the optical fiber 90 in the image 80. Alternatively, when the optical fiber 90 is closer to the distal end 30D, additional pixels can be used to display the optical fiber 90 in the image 80. For example, 100 pixels can be used to display the distal end of the optical fiber 90 in the image 80. The processor 62 can be configured to use the known ratio between the number of pixels associated with the distal end of the optical fiber 90 and the known size of the distal end of the optical fiber 90 to determine the size of the target 150 when the optical fiber 90 is adjacent to the target 150. For example, when the distal end of the optical fiber 90 is adjacent to the target 150, 200 pixels can be used to display the width of the target 150 in the image 80. Therefore, the width of the target 150 can be approximately 2.0 mm. Many other dimensions of the target 150 (e.g., height, cross-sectional diameter, etc.) can also be calculated using this known ratio.

[0039] In some respects, users can manually enter the known distance between target 150 and remote end 30D. For example, users can use the marking 94 on fiber optic cable 90 and / or sheath 92 to determine the distance between target 150 and remote end 30D.

[0040] Additionally or alternatively, image processing techniques performed by processor 62 may include using captured image 80 to calculate the distance between the distal end of fiber optic 90 and the distal end 30D of medical device 10. Therefore, processor 62 may be configured to calculate the distance between the proximal surface / face of target 150 and the distal end 30D of medical device 10. For example, the distance from distal end 30D to target 150 may be used to further assist in generating a 3D image of target 150.

[0041] In this disclosure, the distance from the distal end 30D to the target 150 can be determined based on the known width of the fiber optic cable 90. For example, the width of the distal end of the fiber optic cable 90 can be determined in pixels based on the captured image 80 (e.g., via processor unit 62). The pixel-level width of the distal end of the fiber optic cable 90 can be compared manually or automatically with a calibration table, for example, via processor unit 62. Calibration can be performed to correlate the pixel-level fiber width in the image with the distance between the tip of the fiber optic cable 90 and the imager 42 (i.e., the distance between the tip of the fiber optic cable 90 and the distal end 30D of the axis 30 including the imager 42). In some aspects, processor 92 can store calibration parameters based on the known dimensions of the fiber optic cable 90, such as calibration performed before use. For example, the fiber optic cable 90 can extend a first distance from the distal end 30D. A first image can be generated (e.g., similar to image 80). The pixel width of the fiber optic cable 90 in the first image can then be correlated with the first distance. The fiber optic cable 90 can then extend a second distance. A second image can be captured. The pixel width of the fiber optic cable 90 in the second image can then be correlated with the second distance. Fiber 90 can extend more or less from the distal end 30D, and more images can be captured to increase the number of data points used for calibration. During the procedure, processor 92 can then use the pixel width and distance data of fiber 90 to determine one or more measurements of target 150. Exemplary calibration data are provided in Table 1 below.

[0042] Table 1

[0043]

[0044] Figure 3 An exemplary method 200 for analyzing a target (e.g., target 150) in a subject's body is illustrated. Method 200 can be performed using any medical system or device discussed herein (e.g., medical system 100). For example, in step 202, the distal end 30D of medical device 10 may be introduced into the subject's body cavity and advanced to a position close to target 150. Before, during, or after the distal end 30D approaches target 150, an instrument, such as an optical fiber 90, may be inserted through the working channel 34 of axis 30. In step 204, the distal end of optical fiber 90 may contact (adjacent to or touch) target 150. For example, optical fiber 90 may extend distally relative to the distal end 30D until the distal end of optical fiber 90 adjoins target 150. Additionally or alternatively, medical device 10 may be moved distally such that the distal end of optical fiber 90 adjoins target 150. Medical professionals or other users can confirm that the fiber optic cable 90 is in contact with the target 150 by visual confirmation (e.g., observing the distal end of the fiber optic cable 90 in contact with the target 150, or optionally by observing the movement of the target 150 due to contact with the fiber optic cable 90) and / or by tactile feedback.

[0045] In step 206, for example, when the fiber optic 90 contacts the target 150, one or more images may be generated (e.g., see...). Figure 2 Image 80 in the image. In some aspects, one or more images may be transferred and stored in the processor of the medical system (e.g., processor 62) and / or in memory associated with any other aspect of the medical system. In some aspects, one or more images may be generated and saved to external memory (e.g., an external database). In step 208, the processor may process image 80, for example, by performing segmentation of the target and / or instrument.

[0046] In step 210, target 150 may be rotated, for example, by contact with optical fiber 90 and / or fluid (e.g., liquid or gas). For example, a medical device may be used to deliver liquid and / or gas to target 150 to rotate it. Target 150 may be rotated (e.g., less than 360 degrees, less than 270 degrees, or less than 180 degrees) such that at least one feature detected during segmentation is in the field of view. For example, target 150 may be rotated such that at least a portion of the surface of target 150 displayed in a previous image is also displayed in a subsequent image.

[0047] Once target 150 is rotated to change its orientation relative to the instrument (e.g., fiber optic 90) and relative to the imager of the medical device (e.g., imager 42), steps 202-210 can be repeated once or multiple times. For example, fiber optic 90 can contact target 150 (e.g., step 204), causing partial rotation of target 150 and generating one or more subsequent images (e.g., step 206). As described above, image processing can be performed on the newly generated images (e.g., step 208). For example, segmentation can be performed on the newly generated images. Processor 62 can be configured to identify one or more features in each subsequent image. With the repetition of steps 202-210, more features can be detected, and more measurements of target 150 can be calculated.

[0048] In step 212, processor 62 can be configured to perform a three-dimensional (3D) reconstruction of target 150. For example, the generated images and optional related data can be compiled to generate a 3D representation of target 150. In some aspects, the 3D representation of target 150 generated by processor 62 can be displayed on display 12. Processor 62 can be configured to perform the image processing described above on each image in real time (e.g., during the program). In other aspects, processor 62 can be configured to save each image and perform the image processing described above on each image at a later time (e.g., after the program). As more images are generated, a clearer 3D image of target 150 can be generated.

[0049] When generating a 3D image, representation, or reconstruction of target 150, the medical system can provide information about the size (depth, length, and / or width), volume, and / or shape of target 150. For example, this information can be used to determine how to remove target 150. For instance, the dimensions of target 150 can be used to determine whether target 150 can be removed via the working channel 34 of medical device 10, or whether it is appropriate to reduce the size of target 150 before removal. For example, a medical professional can perform lithotripsy or other procedures on target 150. In some aspects, the determined dimensions and / or other information of target 150 can be stored and compared with target 150 at later points in time, for example, to determine whether target 150 has grown, shrunk, and / or otherwise changed over time.

[0050] Figure 4A and Figure 4B Exemplary images 380A and 380B generated for another target 350 according to aspects of this disclosure are shown. Target 350 is depicted as a kidney stone, but can be any anatomical structure or foreign body. Figure 5 An alternative exemplary method 400 for analyzing target 350 using images 380A and 380B is shown. Method 400 can be performed using any medical system, device, or part of a system discussed herein (e.g., medical system 100). In step 402, a medical device (e.g., medical device 10) can be introduced into the subject's body cavity to a position close to target 350. As target 350 is located and in the field of view of the imager of the medical device, image 380A can be generated in step 404. Figure 4A Image 380A may be stored in a processor (e.g., saved to the memory of processor 62). Processor 62 may be configured to determine the size of target 350, for example, by utilizing Simultaneous Localization and Mapping (SLAM) techniques. In some aspects, these techniques may be used to estimate the size of target 350 and / or generate a 3D model / image of target 350. For example, in step 406, processor 62 may perform image processing on image 380A. Image processing may include segmentation and / or feature extraction of target 350. For example, processor 62 may identify at least one point or region 352 of the target, such as on the proximal surface of target 350. At least one point or region 352 may be at or near the outer edge of target 350 visible in image 380. In other aspects, at least one point or region 352 may be near the center of target 350.

[0051] In step 408, the target 350 can be rotated to change the orientation between the target 350 and the fiber 90 and / or between the target 350 and the instrument. Figure 4B An exemplary image 380B is shown, in which the target 350 is relative to... Figure 4AThe position of the target 350 shown is rotated. For example, an instrument (e.g., the aforementioned fiber optic 90 or any other instrument) can be used to rotate the target 350. Additionally or alternatively, a fluid (e.g., liquid or gas) can be delivered (e.g., via medical device 10 or another instrument) to rotate the target 350. The target 350 can be rotated in any direction (e.g., less than 180 degrees) such that at least one point or region 352 detected during feature extraction of the target 350 from image 380A remains within the field of view.

[0052] Once the target 350 has been rotated, steps 402-408 can be repeated once or multiple times. For example, the target 350 can be repositioned by moving the medical device 10 within the subject's body (e.g., step 402). An image of the target 350 can be generated (e.g., step 404). The processor 62 can be configured to perform image processing on the generated image (e.g., step 406). For example, segmentation and / or feature extraction can be performed on the newly generated image. The processor 62 can be configured to identify at least one point or region 352 between each subsequent image. The target 350 can then be rotated again (e.g., step 408). As steps 402-408 are repeated, more features of the target 350 can be detected.

[0053] In the final step 410, the processor 62 can be configured to analyze the size of the target and / or generate a 3D image of the target 350. For example, a 3D image of the target 350 can be generated using data collected from segmentation and / or feature extraction of each of the images (e.g., images 380A, 380B, etc.).

[0054] While the principles of this disclosure are described herein with reference to illustrative aspects of specific medical uses and procedures, this disclosure is not limited thereto. Those skilled in the art and those who access the teachings provided herein will recognize that additional modifications, applications, aspects, and substitutions of equivalents fall within the scope of the aspects described herein. Therefore, this disclosure should not be considered limited by the foregoing description.

Claims

1. A medical system comprising: A medical device comprising a handle and a shaft defining a working channel having a distal opening at a distal end of the shaft, the distal end further comprising an imager; processor; as well as An instrument that can move along the working channel to contact a target on the far side of the distal end of the shaft; The processor is configured to determine the depth of the target based on pixel characteristics of the target and the instrument in at least one image generated by the imager, and based on the proximity of the instrument to the target in the at least one image.

2. The medical system according to claim 1, wherein, The handle of the medical device includes the processor.

3. The medical system according to claim 1 or 2, wherein, The instrument has a known diameter, and the processor is configured to further determine the depth of the target based on the known diameter of the instrument and the contact between the instrument and the target.

4. The medical system according to any one of the preceding claims, wherein, The processor is configured to determine the depth of the target based on a comparison of the pixel characteristics of the instrument in the at least one image with the pixel characteristics of the target.

5. The medical system according to any one of the preceding claims, wherein, In at least one image, the distal end of the instrument is adjacent to the target.

6. The medical system according to any one of the preceding claims, wherein, The instrument includes an optical fiber, optionally including a laser optical fiber configured to shatter the target.

7. The medical system according to any one of the preceding claims, wherein, The at least one image comprises multiple images, and in each of the multiple images, the target has a different orientation relative to the instrument.

8. The medical system according to any one of the preceding claims further includes a display configured to display the depth of the target determined by the processor using the at least one image.

9. The medical system according to any one of the preceding claims, wherein, The processor is also configured to perform segmentation on the at least one image.

10. The medical system according to any one of the preceding claims, wherein, The processor is also configured to determine the length and / or width of the target based on the pixel characteristics of the target and the instrument in the at least one image, and based on the proximity of the instrument to the target.

11. The medical system according to any one of the preceding claims, wherein, The processor is configured to generate a three-dimensional representation of the target.

12. The medical system according to any one of the preceding claims, wherein, The processor stores the known diameter of the instrument and / or is configured to prompt the user to input the known diameter of the instrument.

13. The use of a medical system according to any one of the preceding claims for determining the depth of said target, wherein, The target is kidney stones.

14. The use according to claim 13, wherein, The application also includes generating a three-dimensional image of the target.

15. The use according to claim 13 or 14, wherein, The processor determines the depth of the target based on the pixel characteristics of the target in multiple images and the pixel characteristics of the instrument.

Images