Composition analysis techniques for ultrasonic ablation

Abstract

To provide techniques for estimating composition of a biological sample during an ablation procedure.SOLUTION: Techniques for estimating composition of a biological sample during an ablation procedure are provided. In an example, a composition detector system can include a probe, an illumination source, and a spectrometer. In an example, the probe can extend through a working channel of a viewing scope and can convey mechanical, acoustical, or ultrasonic energy to tissue of a patient to ablate the tissue at a distal end of the probe. A portion of the tissue may be illuminated at the distal end of the probe or as the portion is being evacuated and collected for disposal by the illumination source. The illumination can generate response illumination that can be received by the spectrometer. The spectrometer can analyze the response illumination and provide an estimate of the composition of the portion of tissue.SELECTED DRAWING: Figure 2

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Provisional Patent Application No. 63 / 071,208, filed August 27, 2020, the contents of which are incorporated herein by reference in their entirety.

[0002] This document relates to ablation techniques for destroying or removing biological tissue, and more specifically, to techniques for analyzing the composition of biological tissue during an ablation procedure. [Background technology]

[0003] Medical scopes, such as endoscopes and laparoscopes, were first developed in the early 1800s and have been used to examine the inside of the body. A medical scope may include a probe having a distal end with tools that allow for capturing optical or electronic images, and a proximal end with controls for manipulating these tools and devices for viewing the images. A shaft may pass signals and provide a connection between the proximal and distal ends of the scope. Some medical scopes allow a user to pass a tool or treatment down a channel in the shaft, for example to remove tissue or retrieve an object.

[0004] Over the past few decades, several advances have been made in the field of endoscopy and especially with regard to the destruction of physiological stones in the bile ducts, urinary tract, kidneys, and gallbladder. Physiological stones in these areas, sometimes called stones, can block the ducts and cause considerable pain to the patient. Treatment can include removing or destroying the stone. Different techniques have been developed to destroy stones, including ultrasonic lithotripsy, pneumatic lithotripsy, electrohydraulic lithotripsy (EHL), and the disintegration of stones using green light, YAG, or holmium lasers. Summary of the Invention [Problem to be solved by the invention]

[0005] Techniques are provided for estimating the composition of a biological sample during an ablation procedure. [Means for solving the problem]

[0006] In one example, a composition detector system can include a probe, an illumination source, and a spectrometer. In one example, the probe can extend through a working channel of a viewing scope and can transmit mechanical, acoustic, or ultrasonic energy to tissue of a patient to ablate the tissue at a distal end of the probe. A portion of the tissue can be illuminated by an illumination source at the distal end of the probe or as the portion is ejected and collected for disposal. The illumination can generate a response illumination that can be received by the spectrometer. The spectrometer can analyze the response illumination and provide an estimate of the composition of the portion of the tissue.

[0007] This section is intended to provide an overview of the subject matter of this patent application. It is not intended to provide an exclusive or exhaustive description of the invention. The detailed description is included to provide further information about this patent application. [Brief description of the drawings]

[0008] [Figure 1] 1 illustrates an example of a portion of an ablation system generally. [Diagram 2] 1 illustrates generally a portion of an example mechanical ablation system for in situ composition detection. [Diagram 3] 1 illustrates generally one example mechanical ablation system for in situ compositional detection. [Figure 4] 1 illustrates generally one example mechanical ablation system for in situ compositional detection. [Diagram 5] 5 illustrates an example of a mechanical ablation probe that can provide one or more optical paths for use with the example ablation systems of FIGS. 1-4. [Figure 6]5 illustrates an example of a mechanical ablation probe that can provide one or more optical paths for use with the example ablation systems of FIGS. 1-4. [Figure 7] 5 illustrates an example of a mechanical ablation probe that can provide one or more optical paths for use with the example ablation systems of FIGS. 1-4. [Figure 8] 5 illustrates an example of a mechanical ablation probe that can provide one or more optical paths for use with the example ablation systems of FIGS. 1-4. [Figure 9] 1 illustrates a portion of an example mechanical ablation system that includes a composition detector configured to sense ablated material in a material management system and to determine composition information of the sensed ablated material. [Figure 10A] 13A-13C are graphs illustrating an example of how a feedback analyzer can determine the size and density of a biological sample. [Figure 10B] 13A-13C are graphs illustrating an example of how a feedback analyzer can determine the size and density of a biological sample. [Figure 11] 1 illustrates a portion of an example mechanical ablation system. [Figure 12] 1 illustrates a portion of an example composition detector configured to redirect ablated material in an exhaust path of an exhaust system for compositional analysis. [Figure 13] Generally, an example of a method for ablating a biological sample and analyzing the biological sample during the ablation procedure and within a system used for the ablation procedure is presented. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0009] Several devices have been developed that use mechanical energy to break up stones into smaller fragments to facilitate removal from the patient's urinary system. In some instances, ultrasonic or acoustic frequency energy can be delivered by transmitting down a rigid shaft and contacting the stone. Many procedures use such devices in a system that also includes a medical scope that allows the shaft to enter a confined area within the patient's body. Such systems also include a material management system that irrigates the area of ​​interest near the stone and removes stone fragments once the stone is ablated. Users of ablation equipment have recognized that knowing the composition of the stone can assist in providing more efficient treatment. However, conventional techniques require a portion of the stone or one of the stones to be removed from the patient and analyzed outside of the ablation system. Such techniques can be time consuming and can result in a significant delay between the time the sample is removed from the system and the time the compositional analysis is completed. Such delays are often weighed against completing the procedure in a more timely but inefficient manner without the benefit of the compositional information. The inventors have recognized techniques for analyzing and providing compositional information about the stone composition within the ablation system and as the ablation procedure progresses. These new technologies may include systems with in situ or near in situ analytical capabilities that may allow an operator of the ablation system to tailor the ablation treatment to the composition of the stone as it is being fragmented.

[0010] FIG. 1 generally illustrates an example of a portion of an ablation system 100. The system may include an ablation controller 102 and an ablation instrument 103. In some examples, a working lumen, or access port, of a viewing instrument 107 may allow for at least a portion of an ablation probe 104 of the ablation instrument 103 to be inserted into an internal structure or region of a patient. In some examples, the viewing instrument may include an endoscope, laparoscope, or other medical scope. Such a scope may include one or more optical paths, optical sensors, and additional working lumens. The optical path may be used to transmit light to a distal end of the viewing instrument, and an optical sensor, such as a camera, may be used to transmit an image type signal to an imaging system coupled to a proximal end of the viewing instrument.

[0011] The ablation system 100 can include a mechanical ablation controller 109, a material management system 130. The mechanical ablation controller can include a mechanical energy source, associated controls, and accessories that provide mechanical energy to, for example, the ablation instrument 103. The mechanical energy source can deliver acoustic energy at one or more acoustic energy frequencies and at one or more acoustic energy amplitudes. The acoustic energy can be both sonic and ultrasonic frequencies. In some examples, the mechanical energy source can include one or more piezoelectric transducers and mechanical couplings configured to generate acoustic energy at one or more frequencies.

[0012] The material management system 130 can cooperate with the ablation instrument 103 to, for example, irrigate the distal end of the ablation instrument 103, aspirate or evacuate material from the distal end of the ablation instrument 103, or both. In some examples, the material management system 130 can be part of an endoscopic system. In some examples, the material management system 130 can include a composition detector 145 that is optionally configured to sample and analyze stone fragments captured by the material management system.

[0013] The ablation instrument 103 can include a handle 111 that can be located at the proximal end of the ablation probe 104. In some examples, when the ablation procedure is performed robotically, a second handle can be located remotely. The handle 111 can include one or more electrical, mechanical, optical or other interfaces, for example, for connecting to the mechanical ablation controller 109 or the material management system 130. The handle 111 can include one or more intermediate accessories, such as one or more triggers, buttons, etc., for actuating the provision of mechanical energy to the ablation probe 104. The ablation probe 104 can include a tube 113 for transmitting mechanical energy, for example, from an electromechanical or other transducer in the handle 111 to a distal end of the tube 113. Such an ablation probe can be referred to as an acoustic transmission probe. The ablation probe 104 can also include an optical path 114 for transmitting an optical signal, for example, from the distal end of the tube 113 to a composition detector 145, optionally configured to sample and analyze stones in situ at the distal end of the ablation probe 104. In some examples, the optical fiber of the optical path 114 can be mounted on or integrated with the tube 113. The distal end of the ablation probe 104 can be inserted toward a target site and used to break up or apply mechanical energy therapy to stones or biological samples located near the distal end of the tube 113. In some examples, an internal channel of the tube 113 can provide a channel that allows, for example, irrigation of a target area at or near the distal end of the tube 113, or aspirating or evacuating obstructions or other target tissue debris from the patient's body. In some examples, a gap formed within the working channel 105 but outside the tube 113 can be used for irrigation of a target area at or near the distal end of the tube 113, or aspirating or evacuating obstructions or other target tissue debris from the patient's body.In some instances, a gap formed within working channel 105 but outside of tube 113 can be used for complementary material management functions compared to the interior channel of tube 113. For example, in some instances, when the interior channel of tube 113 is used for aspiration, the gap between working channel 105 and the exterior of tube 113 can be used for irrigation, and vice versa.

[0014] FIG. 2 generally illustrates a portion of an example mechanical ablation system 200 for in situ composition detection. In comparison to FIG. 1, FIGS. 2, 3, and 4 illustrate a system specific to sensing and detecting the composition of the target tissue at the end of the ablation probe 204, 304, rather than when the target tissue is being evacuated for collection as shown in FIGS. 9-12. The mechanical ablation system 200 can include a viewing instrument 207, such as an endoscope or laparoscope, a first light source 206 separate from the viewing instrument 207, a mechanical ablation controller 209, an ablation probe 204, a spectrometer 208, and an optional spectrum analyzer 210. The viewing scope 207 may or may not provide a second light source. The viewing instrument 207 can provide a working channel 205 for inserting the ablation probe 204 into the target site. In some examples, the mechanical ablation controller 209 can provide signals and actuation to mechanically ablate a biological specimen 217 located at a distal end 219 of the ablation probe 204. It is understood that a transducer for converting the ablation signal into mechanical energy can be located in the ablation probe 204 or between the ablation probe 204 and the actual control circuitry of the mechanical ablation controller 209. Light from a first light source 206 can be transmitted through one or more optical paths 211 of the ablation probe 204 to a distal end 219 of the ablation probe. The light of the first light source 206 can illuminate an area near the distal end 219 of the ablation probe 204 that includes a biological specimen 217, such as a stone. The light of the first light source 206 can generate a responsive illumination that is captured by an optical sensor 212 of the observation instrument 207. In some examples, the optical sensor 212 can be a camera. The signal from the optical sensor 212 can be received by a spectrometer 208, which can provide spectral information about the biological sample 217 at the distal end 219 of the ablation probe 204. In some examples, the spectral information can be displayed to a user, who can make adjustments to the ablation treatment based on the spectral information.In some examples, optional spectrum analyzer 210 can receive spectral information from spectrometer 208 and can provide more specific compositional information to a user. In some examples, optional spectrum analyzer 210 can determine more specific compositional information based on the spectral information received from spectrometer 208 and can make automatic corrections to the mechanical ablation treatment via mechanical ablation controller 209 to provide closed-loop control of the ablation treatment.

[0015] FIG. 3 generally illustrates an example mechanical ablation system 300 for in situ composition detection. The mechanical ablation system 300 can include a viewing instrument 307, such as an endoscope or laparoscope, a first light source 306 separate from the viewing instrument 307, a mechanical ablation controller 309, an ablation probe 304, a spectrometer 308, and an optional spectrum analyzer 310. The viewing scope 307 may or may not provide a second light source. The viewing instrument 307 can provide a working channel 305 for inserting the ablation probe 304 into a target site. In some examples, the mechanical ablation controller 309 can provide signals and actuation to mechanically ablate a biological specimen 317 located at a distal end 319 of the ablation probe 304. It is understood that a transducer for converting the ablation signal to mechanical energy can be located in the ablation probe 304 or between the ablation probe 304 and the actual control circuitry of the mechanical ablation controller 309. Light from a first light source 306 can be transmitted to a distal end of the ablation probe 304 via one or more optical paths 311 of the ablation probe 304. The light of the first light source 306 can illuminate an area near the distal end 319 of the ablation probe 304 that includes a biological specimen 317, such as a stone. The light of the first light source 306 can generate a response illumination that can be captured by a second optical path 312 of the ablation probe 304. Optionally, the response illumination can also be captured by an optical sensor 312 of the observation instrument 307. In some examples, the optical sensor 312 can be a camera. In some examples, a signal from the optical sensor 312 can be received to provide a visual image to an operator of the mechanical ablation system 300.

[0016] The response illumination captured by the second optical path 312 can be received by a spectrometer 308, which can provide spectral information about the biological sample 317 at the distal end 319 of the ablation probe 304. In some examples, the spectral information can be displayed to a user, who can make adjustments to the ablation treatment based on the spectral information. In some examples, an optional spectrum analyzer 310 can receive the spectral information from the spectrometer 308 and provide more specific compositional information to a user. In some examples, the optional spectrum analyzer 310 can determine more specific compositional information based on the spectral information received from the spectrometer 308 and can make automatic corrections to the mechanical ablation treatment via the mechanical ablation controller 309 to provide closed-loop control of the ablation treatment.

[0017] FIG. 4 generally illustrates an example mechanical ablation system 400 for in situ composition detection. The mechanical ablation system 400 can include a viewing instrument 407, such as an endoscope or laparoscope, a first light source 406, a mechanical ablation controller 409, an ablation probe 404, a spectrometer 408, and an optional spectrum analyzer 410. The viewing scope 407 can provide a light path 414 separate from the ablation probe 404. The viewing instrument 407 can provide a working channel 405 for inserting the ablation probe 404 into a target site. In some examples, the mechanical ablation controller 409 can provide signals and actuation to mechanically ablate a biological specimen 417 located at a distal end 419 of the ablation probe 404. It is understood that a transducer for converting the ablation signal to mechanical energy can be located in the ablation probe 404 or between the ablation probe 404 and the actual control circuitry of the mechanical ablation controller 409. Light from the light source 406 can be transmitted via an optical path 414 of the viewing instrument 407 to a distal end 419 of the viewing instrument 407. The light from the light source 406 can illuminate an area near the distal end 419 of the ablation probe 404 that includes a biological specimen 417, such as a stone. The light from the light source 406 can generate a response illumination that can be captured by an optical path 411 of the ablation probe 404. Optionally, the response illumination can be captured by an optical sensor 412 of the viewing instrument 407. In some examples, the optical sensor 412 can be a camera. In some examples, a signal from the optical sensor 412 can be received to provide a visual image to an operator of the ablation system 400.

[0018] The response illumination captured by the optical path 411 of the ablation probe 404 can be received by a spectrometer 408, which can provide spectral information about the biological sample 417 at the distal end 419 of the ablation probe 404. In some examples, the spectral information can be displayed to a user, who can make adjustments to the ablation treatment based on the spectral information. In some examples, an optional spectral analyzer 410 can receive the spectral information from the spectrometer 408 and provide more specific compositional information to a user. In some examples, the optional spectral analyzer 410 can determine more specific compositional information based on the spectral information received from the spectrometer 408 and can make automatic corrections to the mechanical ablation treatment via the mechanical ablation controller 409 to provide closed-loop control of the ablation treatment.

[0019] In some examples, the light source 406 can include a light emitting diode (LED). In some examples, the light source 406 can include multiple LED illumination sources, with each LED illumination source providing a different color of light than the other LED illumination sources. In some examples, the activation of the colors of the light source 406 can be sequenced to illuminate an area near the distal end 419 of the ablation probe 404 with what appears to be white light. However, this sequencing can be synchronized with the spectrometer 408 to reduce noise for spectral measurements in the respective narrow ranges of wavelengths associated with each color. In some examples, spectral measurements and determinations can be made faster and more accurately than a light source providing random light from the entire visible spectrum.

[0020] 5-8 show examples of ablation probes that can provide one or more optical paths for use with the example ablation systems of FIGS. 1-4. In addition to transmitting acoustic energy to fragment target tissue, the probes also provide optical paths to illuminate the target or collect response illumination for real-time compositional analysis of the target tissue. The probes of FIGS. 5-8 can be used with the systems of FIGS. 9-12, but the real-time compositional analysis feedback of these systems is based on response illumination collected from the exhaust path of the material management system. As used herein, "real-time" or "near real-time" refers to a system in which input data (e.g., response illumination) is processed by the system rather than external to the system, and the processed information (e.g., output of compositional analysis) is immediately available as feedback, and any delay between receipt of the input and availability of the processed feedback is a delay generated by the system equipment.

[0021] FIG. 5 generally illustrates a view of the distal end of one example of a portion of an ablation probe 504 that can be used with one or more of the example systems of FIGS. 1-4. The ablation probe 504 can include a metal or other rigid tube 513 for delivering, for example, mechanical ablation energy from an electromechanical or other transducer to a biological specimen at or near the distal end of the ablation probe 504. Although a flexible or semi-rigid tube can be used to navigate a tortuous path to a destination, a rigid tube, while less maneuverable, transmits the mechanical ablation energy much more efficiently and with less loss than a semi-rigid or flexible tube. Mechanical ablation of a biological specimen, such as a kidney stone, can include positioning the distal end of the tube 513 against the target stone and mechanically vibrating or oscillating the tube 513. The tube 513 can include one or more holes 520 or passages running longitudinally or lengthwise along the tube 513, for example in a sidewall of the tube 513. 5 shows two holes 520a, 520b in the sidewall of the tube 513, however, the tube 513 may include one or more additional optional holes 520. One or more optical fibers 521 may be positioned to extend into a respective one of the sidewall holes 520a, 520b. The one or more optical fibers may be used to transmit light between the ends of the tube 513, for example, to transmit light to illuminate the distal end of the ablation probe 504 or to transmit responsive illumination to the proximal end of the probe 504.

[0022] In addition to providing a transmission mechanism for delivering mechanical energy to the target, the tube 513 can provide a central or other longitudinal lumen, for example, to irrigate or evacuate an area near the distal end of the probe 504. More than one group or bundle of optical fibers 521 can extend longitudinally through the wall of the tube 513, for example, at different circumferential or peripheral locations, or offset, for example, by at least 5 degrees or more around the circumference defined by the tube. In some examples, the tube 513 can be hollow to define an internal channel that can be used to irrigate or evacuate or aspirate material near the distal end of the probe 504.

[0023] FIG. 6 generally illustrates a view of the distal end of one example of a portion of an ablation probe 604 that can be used with one or more of the example systems of FIGS. 1-4. The ablation probe 604 can include a metal or other rigid tube 613 for delivering mechanical ablation energy to an obstacle or other target located, for example, at or near the distal end of the ablation probe 604 of FIG. 6. One or more optical fibers 621 can extend within or along the tube 613 such that they can be used to apply laser energy to the obstacle. For example, the optical fibers 621 can be held against the exterior surface of the tube 613 by a layer of material, such as, for example, a heat shrink or other shrink wrap type material, a cover material, or a bonding material 622. Any voids between the cover material and the exterior surface of the tube 613, for example, near the optical fibers 621, can be filled with a surgical grade silicone or other sealant 623. More than one group or bundle of optical fibers 621 can extend longitudinally along the exterior of the tube 613, for example, at different circumferential or peripheral locations, or offset, for example, by at least 5 degrees or more around the exterior of the tube. In some instances, the tube 613 may be hollow to define an interior channel that may be used to irrigate or evacuate or aspirate material near the distal end of the probe 604.

[0024] FIG. 7 generally illustrates a view of the distal end of one example of a portion of an ablation probe 704 that can be used with one or more of the example systems of FIGS. 1-4. The ablation probe 704 can include a metal or other rigid tube 713 for delivering mechanical ablation energy, for example, to an obstacle or other target. One or more optical fibers 721 can extend along the tube 713 such that they can be used to apply laser energy to an obstacle or other target located at or near the distal end of the probe 704. The bundle or other arrangement of optical fibers 721 can be held against the exterior surface of the tube 713 with, for example, a covering or bonding material, such as, for example, a heat shrink or other shrink wrap material. Near the distal end of the tube 713, the optical fibers 721 can follow a recess in the exterior of the tube 713 and transition via an inlet into a hole 720 in a sidewall of the tube 713 that can provide a passage for the optical fibers 721 to the termination of the hole 720 at the distal end of the tube 713. The gap between the cover material and the exterior surface of the tube 713, for example near the optical fibers 721, can be filled with a surgical grade silicone or other sealant. One or more groups or bundles of optical fibers 721 can extend along the exterior of the tube 713 before transitioning via inlets to corresponding holes that provide a passageway in the sidewall of the tube 713. Such additional inlets can be angularly offset from the other inlets by 5 degrees or more relative to the centerline of the tube 713. In some examples, the tube 713 can be hollow to define an interior channel that can also be used to irrigate or evacuate or aspirate material near the distal end of the probe 704.

[0025] FIG. 8 generally illustrates a view of the distal end of one example of a portion of an ablation probe 804 that can be used with one or more of the example systems of FIGS. 1-4. The ablation probe 804 can include a metal or rigid tube 813, for example, for delivering mechanical ablation energy to an obstruction. One or more optical fibers 821 can extend along the tube 813 such that they can be used to apply laser energy to the obstruction or other target. The tube 813 can include one or more recessed channels 823 on and along an exterior surface of the tube 813, for example, for carrying one or more optical fibers 821. The optical fibers 821 can be held within the channels of the tube 813 by, for example, a covering or bonding material, such as a heat shrink or other shrink wrap material. Any voids between the covering material and the exterior surface of the tube 813, for example, near the optical fibers 821, can be filled with a surgical grade silicone or other sealant. The multi-modality probe 804 can include more or fewer bundles of optical fibers 821 than those shown in FIG. 8.

[0026] 9 shows a portion of an example mechanical ablation system 900 including a composition detector 945 configured to sense ablated material in a material management system 930 and to determine composition information of the sensed ablation material. The portion of the example mechanical ablation system 900 can include a portion of the material management system 930, an ablation probe 904, a light source 906, an optical detector 912, a feedback analyzer 910, and a mechanical ablation controller 909.

[0027] A mechanical ablation controller 909 can be used to generate and modulate signals for generating mechanical ablation energy. In some examples, the mechanical ablation controller 909 can include a transducer for generating mechanical ablation energy. In some examples, the transducer can be present in the ablation probe 904 or in the handle 911 of the ablation probe. It is understood that the ablation probe 904 can extend through a lumen of a viewing instrument in some examples, such as the examples shown in Figures 1-4. The material management system 930 can include an exhaust path 931 for irrigation and removal of ablated biological material from the distal end of the ablation probe 904. In some examples, the exhaust path 931 can terminate in a collection system so that the ablated and other materials can be appropriately contained and disposed of.

[0028] The exhaust path 931 can include an optically transparent portion 932. The light source 906 can be positioned to allow light to pass through the optically transparent portion 932 of the exhaust path 931. The optical sensor 912 can be positioned on the opposite side of the transparent portion 932 from the light source 906 and can have a sensing surface focused toward the light source 906. As the ablated material 922 passes through the transparent portion 932, the optical sensor 912 can gather information about the composition of the ablated material 922. The feedback analyzer 910 can receive a signal from the optical sensor 912 and can analyze the signal for a compositional characteristic of the ablated material 922 that is detected. The compositional characteristic can include, but is not limited to, size, density, chemical composition, shape, or a combination thereof. The detection of each compositional characteristic can depend on the sophistication of the light source 906 and the optical sensor 912. FIGS. 10A and 10B show an example of how the feedback analyzer can determine size and density. 10A and 10B show intensity signals provided by the optical sensor as the sensor detects two pieces of ablated material passing through the exhaust path between the light source and the optical sensor. Each piece of material is detected via a decrease or drop in the intensity of the light received from the light source. The relative size 1090 of each piece can be detected by comparing the length of time of each drop. In some examples, the system can include flow information provided by either an evaluation system or a dedicated sensor. The flow information can assist in providing a measured size 1010 for each piece. In some examples, the optical sensor can include an array of optical sensors such that images can be captured and analyzed to provide size information. The piece shown in FIG. 10B does not have as large a drop as the drop shown in FIG. 10A. The difference in the depth of the drop can indicate that the ablated fragment detected in FIG. 10A is denser than the ablated fragment detected in FIG. 10B. In some examples, a combination of the intensity level and size of the fragments can be used to estimate the absolute density or hardness of the current material being ablated.As discussed below, such estimates can then be used to provide real-time feedback to the mechanical ablation controller. The parameters of the mechanical ablation controller can be adjusted based on the feedback so that the current treatment can be applied more efficiently, or as efficiently as the mechanical ablation controller can apply the treatment. The parameters of the mechanical ablation controller that can be adjusted include, but are not limited to, the drive signal shape (e.g., sine wave, square wave, sawtooth wave, etc.), frequency (e.g., fixed or continuous sweep), amplitude (e.g., fixed or continuous sweep), pulse width and pulse frequency, or combinations thereof.

[0029] Referring again to FIG. 9 , in some examples, the optical sensor 912 can provide a spectrometer or can actually be a spectrometer. In some examples, the optical sensor 912 can measure the flow velocity as the edge of the stone fragment 922 moves through the field of view of the optical sensor 912. In some examples, the analyzer can integrate the size of the stone fragment 922 over a period of time to estimate the mass or volume of the ablated stone 917. In some examples, the detection information from the optical sensor 912, the analysis information from the feedback analyzer 910, or a combination of the detection information from the optical sensor 912 and the analysis information from the feedback analyzer 910 can be passed to an artificial intelligence or machine learning application, such as a cloud 935 based application, for further processing. In such applications, the ongoing treatment can be further adjusted for more efficient treatment by combining with other treatment information from regional, national or global treatment locations as well as historical treatment information from local treatment locations.

[0030] FIG. 11 illustrates a portion of an example mechanical ablation system 1100. The system 1100 is shown to ablate biological material 1117, such as stones, via mechanical ablation, and to evacuate stone fragments 1122 via an evacuation path 1131, which may include a tube and a handle of an ablation probe 1104. A portion of the system 1100 may include a composition detector 1145 configured to sense the ablated material or stone fragments 1122 in the evacuation path 1131 of the material management system 1130, and to determine composition information of the stone fragments 1122. The system may also include an ablation instrument 1103 and an ablation controller 1109. The ablation instrument 1103 may include an ablation probe 1104 and a handle 1111, as described above with respect to the example of FIG. 1. It is understood that the ablation probe 1104 may extend through a lumen of a viewing instrument in some examples, such as the examples shown in FIGS. 1-4. The drainage channel 1131 may be part of a drainage system used to irrigate and drain ablated material from the patient, such as the stone fragments 1122. The drainage channel 1131 may include a transparent portion 1132 that facilitates detection of the composition of the stone fragments 1122.

[0031] The composition detector 1145 may generally be located along the evacuation path 1131 between the ablation tool 1103 and a local termination of the evacuation path 1131. Such a local termination may include a collection system or a vacuum source for the evacuation path 1131. The composition detector 1145 may include a light source 1106, an optical sensor system 1112. The optical sensing system 1112 may detect the stone fragments 1122 and analyze the optical response of the stone fragments 1122 to derive composition information for presentation to an ablation system operator or for adjusting treatment in the ablation controller 1109. In some examples, the optical response may include light of the light source reflected by the stone fragments 1122. In some examples, the optical response may be fluorescence generated by the stone fragments 1122 in response to light from the light source 1106. In some examples, the sophistication of the optical sensor system 1112 may determine the composition information provided by the composition detector 1145. For example, a less sophisticated optical sensor system 1112 may provide the size or shape of the stone fragments 1122. A more sophisticated optical sensor system 1112 may also provide color details and surface texture details of the stone fragments 1122. As the sophistication of the optical sensor system increases, additional compositional aspects of the stone fragments 1122 may be determined, and more sophisticated and timely feedback control of the ablation therapy may be achieved. In some examples, the optical sensor system 1112 may include a spectrometer or spectrum analyzer 1110 so that near real-time feedback of the composition of the stone fragments 1122 may be determined and used to adjust the ablation therapy to help provide a more efficient treatment. Such near real-time feedback may include an estimate of hardness, which may have a significant impact on adjusting the ablation energy for efficient delivery of the ablation therapy.

[0032] In some examples, the optical sensor system 1112 can provide details about the ablated stone fragments 1122 to the electronic medical record system 1136. Such details can be used to ensure an accurate history of the patient, as well as to study and improve the composition estimates provided by the composition detector 1145.

[0033] FIG. 12 shows a portion of an example composition detector 1245 configured to divert the ablated material 1222 from the exhaust path 1231 of the exhaust system and to determine composition information of the ablated material 1222. While not so limited, in some examples, the illustrated composition detector 1245 can be used as shown and described below, or can be part of a larger system, such as the mechanical ablation system of FIG. 11 or FIG. 1, or can be in an ablation system using another ablation modality, such as a laser ablation system. In some examples, the composition detector 1245 can include a flow control actuator 1241, an optical sensor system 1212, a light source 1206, and an optional collection chamber 1250. In some examples, the flow control actuator 1241 can be used in conjunction with an upstream sensor and controller to adjust the flow rate of the exhaust path 1231. In such examples, the actuator 1241 can slow or stop the flow to allow the optical sensor system 1212 to collect image information of the stone fragments 1222, such as stone fragments sensed upstream by an upstream sensor. In such applications, composition detector 1245 may not include collection chamber 1250 .

[0034] In some examples, the composition detector 1245 includes a collection chamber 1250 so that the flow actuator 1241 can capture the stone fragments 1222 and move the captured fragments to the collection chamber 1250. In some examples, the collected fragments 1222 can be removed from the collection chamber 1250 for analysis outside the system. In some systems, upon entering the collection chamber 1250, the optical sensor system 1212 can collect illumination responses from the collected fragments 1222 to generate composition information. In some examples, the optical sensor system 1212 can include a spectrometer or can extract spectral information from signals provided by the optical sensor of the optical sensor system 1212. In some examples, the optical sensor system 1212 can include an analyzer 1210 for receiving the spectral information and generating an estimate of the chemical or material composition of the stone fragments 1222. In some examples, the analyzer can provide an estimate of the hardness of the stone fragments 1222. In some examples, the optical sensor system 1212 can provide control signals to an ablation controller to provide closed-loop control of the ablation therapy. In some examples, the optical sensor system 1212 can provide raw or analyzed data to a remote medical system, a remote or cloud-based artificial intelligence system, a remote or cloud-based machine learning system, or a combination thereof.

[0035] FIG. 13 generally illustrates an example of a method 1300 for ablating a biological sample and analyzing the biological sample during an ablation procedure and within a system used for the ablation procedure. At 1301, a biological sample, such as a stone, can be mechanically or acoustically processed via an ablation probe of an ablation system. In some examples, the biological sample can be located within a patient, and the ablation probe can extend into the patient through a working channel of a viewing scope instrument. At 1303, at least a portion of the biological sample can be illuminated by an illumination source. At 1305, an optical response signal can be obtained with an optical sensor in response to illuminating at least a portion of the sample. At 1307, spectral information of the optical response signal can be analyzed at a location on the patient during the same medical procedure as the treatment to determine an indication of a composition of at least a portion of the sample. In some examples, the illumination and analysis of the biological sample can occur as the biological sample is ablated within the patient. In some examples, the illumination and analysis of the biological sample can occur as the biological sample is expelled from the patient, or as the biological sample is expelled from the patient immediately after the biological sample is expelled but still within the exhaust path of a material management system. A material management system can be used to irrigate the ablation area and drain, collect and discard the ablated and irrigation materials. In some examples, estimates of the composition of the biological sample can be used to adjust the ablation treatment.

[0036] Examples and Notes In a first example, Example 1, a combined system for both analyzing a biological sample at a patient location during a medical procedure and also processing the biological sample at the patient location during the same medical procedure may include an acoustic transmission probe configured to extend through a working channel of a viewing scope instrument to acoustically process the biological sample within the patient at a distal end of the probe, an illumination light path configured to illuminate at least a portion of the biological sample, a response light path configured to obtain an optical response signal from at least a portion of the biological sample in response to the illumination, and a spectrometer configured to analyze spectral information of the optical response signal at the patient location during the same medical procedure as the processing to determine an indication of a composition of at least a portion of the sample.

[0037] In Example 2, the subject matter of Example 1 includes wherein the illumination light path is configured to transmit light toward a distal end of the probe.

[0038] In Example 3, the subject matter of any one of Examples 1-2 can optionally further include an illumination light path extending along the probe through a working channel of the observation scope instrument.

[0039] In Example 4, the subject matter of any one of Examples 1-3 can optionally further include a viewing scope instrument, the viewing scope instrument including an illumination light path.

[0040] In Example 5, the subject matter of any one of Examples 1-4 can optionally further include, wherein the observation instrument includes a camera configured to detect an optical response signal for transmission to the spectrometer.

[0041] In Example 6, the subject matter of any one of Examples 1-5 can optionally further include an exhaust path extending from a distal end of the probe and including a channel of the probe, the exhaust path configured to exhaust at least a portion of the biological sample away from the distal end of the probe.

[0042] In Example 7, the subject matter of any one of Examples 1-6 can optionally further include, where the ejection path is accessed by the illumination light path and the response light path to enable illuminating, obtaining an optical response, and analyzing at least a portion of the biological sample while at least a portion of the biological sample is located in the ejection path.

[0043] In Example 8, the subject matter of any one of Examples 1-7 can optionally further include a receptacle configured to receive at least a portion of the biological sample from the discharge path, the receptacle accessed by the illumination light path and the response light path to enable illuminating, obtaining an optical response, and analyzing at least a portion of the biological sample while at least a portion of the sample is located in the receptacle.

[0044] In Example 9, the subject matter of any one of Examples 1-8 can optionally further include at least one or both of the illumination path or the response light path being coupled to at least a portion of the biological sample via at least one optically transparent portion.

[0045] In Example 10, the subject matter of any one of Examples 1-9 can optionally further include, wherein the spectrometer is configured to receive an optical response signal through the transparent portion.

[0046] In Example 11, the subject matter of any one of Examples 1-10 can optionally further include a controller circuit configured to at least one of establish or adjust discharge parameters in response to information including an indication of a composition of at least a portion of the analyzed biological sample.

[0047] In Example 12, the subject matter of any one of Examples 1-11 can optionally further include a controller circuit configured to at least one of establish or adjust acoustic processing parameters in response to information including an indication of a composition of at least a portion of the analyzed biological sample.

[0048] Example 13 is a method of both analyzing a biological sample at a patient location during a medical procedure and also processing a biological sample at the patient location during the same medical procedure, the method including acoustically processing the biological sample within the patient via an acoustic transmission probe extending through a working channel of a viewing scope instrument into the patient, illuminating at least a portion of the sample, obtaining an optical response signal in response to the illumination, and analyzing spectral information of the optical response signal at the patient location during the same medical procedure as the processing to determine an indication of a composition of at least a portion of the sample.

[0049] In Example 14, the subject matter of Example 13 can optionally further include, wherein the illuminating step includes illuminating at least a portion of the biological sample via a first light path extending along the probe through a working channel of the observation scope instrument.

[0050] In Example 15, the subject matter of any one of Examples 13-14 can optionally further include, where acquiring the optical response signal includes transmitting the optical response signal to a local spectrometer via a camera of the observation scope instrument.

[0051] In Example 16, the subject matter of any one of Examples 13-15 can optionally further include, where acquiring the optical response signal includes transmitting the optical response signal to a local spectrometer via a second optical path extending along the probe through a working channel of the observation scope instrument.

[0052] In Example 17, the subject matter of any one of Examples 13-16 can optionally further include ejecting at least a portion of the biological sample from the distal end of the probe toward a local collection receptacle via an ejection path that includes at least a portion of the longitudinal channel of the probe, and the steps of illuminating, acquiring an optical response, and analyzing are performed on at least a portion of the sample while at least a portion of the sample is located in the local collection receptacle.

[0053] In Example 18, the subject matter of any one of Examples 13-17 can optionally further include ejecting at least a portion of the biological sample from the distal end of the probe via an ejection path that includes at least a portion of the longitudinal channel of the probe, and the illuminating, acquiring an optical response, and analyzing steps are performed while at least a portion of the biological sample is being ejected along the ejection path.

[0054] In Example 19, the subject matter of any one of Examples 13-18 can optionally further include at least one or both of the illuminating step or the acquiring an optical response step being performed via at least one optically transparent portion disposed along the exhaust path.

[0055] In Example 20, the subject matter of any one of Examples 13-19 can optionally further include at least one of establishing or adjusting discharge parameters in response to information including an indication of a composition of at least a portion of the analyzed biological sample.

[0056] In Example 21, the subject matter of any one of Examples 13-20 can optionally further include at least one of establishing or adjusting acoustic processing parameters in response to information including an indication of a composition of at least a portion of the analyzed biological sample.

[0057] Example 22 is an ablation instrument for ablating tissue at a distal end of a probe, the ablation instrument including a probe having a distal end configured to extend through a working channel of a viewing instrument, an exhaust path configured to pass a portion of the ablated tissue through the exhaust path, a first portion of the exhaust path including the probe, and a target identification system configured to optically sense the portion of the ablated tissue within the exhaust path, measure an aspect of the portion, and provide a first signal representative of the aspect.

[0058] In Example 23, the subject matter of Example 22 can optionally further include, wherein the exhaust path includes an optically transparent portion disposed between the proximal end of the probe and the collection system.

[0059] In Example 24, the subject matter of any one of Examples 22-23 can optionally further include, where the target identification system includes an illumination source directed at the optically transparent portion.

[0060] In Example 25, the subject matter of any one of Examples 22-24 may optionally further include, wherein the target identification system includes an optical sensor positioned opposite the illumination source relative to the transparent portion, the optical sensor configured to generate a first signal.

[0061] In Example 26, the subject matter of any one of Examples 22-25 can optionally further include, where the target identification system includes a spectrometer configured to receive the response illumination from the optically transparent portion and to generate the first signal.

[0062] In Example 27, the subject matter of any one of Examples 22-26 can optionally further include a flow control configured to receive the first signal and to alter flow of the portion of the ablated tissue in response to the first signal.

[0063] In Example 28, the subject matter of any one of Examples 22-27 can optionally further include, wherein the flow control is configured to capture the portion as a sample in a sample chamber coupled to the exhaust path.

[0064] Example 29 is a method of ablating tissue, comprising applying energy to the tissue via a distal end of an ablation probe; exhausting a portion of the ablated tissue through an exhaust path, the exhaust path including a channel of the ablation probe; optically sensing the portion of the ablated tissue as it moves through the exhaust path, measuring an aspect of the portion, and providing a first signal representative of the aspect.

[0065] In Example 30, the subject matter of Example 29 can optionally further include receiving the first signal on a monitor and displaying the aspect.

[0066] In Example 31, the subject matter of any one of Examples 29-30, wherein the step of applying energy includes a step of applying mechanical ablation energy to tissue, the method can optionally further include a step of receiving a first signal at a source of mechanical ablation energy and adjusting a characteristic of the mechanical ablation energy based on the first signal.

[0067] In Example 32, the subject matter of any one of Examples 29-31 can optionally further include, where optically sensing the portion includes directing illumination through an optically transparent portion of the exhaust path.

[0068] In Example 33, the subject matter of any one of Examples 29-32 can optionally further include, where the step of optically sensing the portion includes a step of directing illumination to the optical sensor through an optically transparent portion of the exhaust path.

[0069] In Example 34, the subject matter of any one of Examples 29-33 can optionally further include, where the measuring step includes measuring a light intensity of the illumination with an optical sensor.

[0070] In Example 35, the subject matter of any one of Examples 29-34 can optionally further include the first signal being based on a light intensity of the illumination.

[0071] In Example 36, the subject matter of any one of Examples 29-35 can optionally further include, where the optically sensing step includes receiving responsive illumination from a transparent portion of the exhaust path with a spectrometer.

[0072] In Example 37, the subject matter of any one of Examples 29-36 can optionally further include, where the measuring step includes a step of measuring spectral information of the responsive illumination.

[0073] In Example 38, the subject matter of any one of Examples 29-37 can optionally further include where the first signal is based on spectral information.

[0074] In Example 39, the subject matter of any one of Examples 29-38 can optionally further include adjusting the flow of ablated tissue through the exhaust path in response to the first signal.

[0075] In Example 40, the subject matter of any one of Examples 29-39 can optionally further include, where adjusting the flow includes capturing the portion in a sample chamber coupled to the exhaust path.

[0076] Example 41 is an apparatus for sensing ablation material, the apparatus including an exhaust path configured to pass irrigation and ablation material from an ablation probe to a collection system, a light source configured to illuminate the irrigation and ablation material in the exhaust path, an optical sensor focused toward the exhaust path, and a controller configured to receive a first signal from the optical sensor and provide measurement information about the ablation material based on the signal.

[0077] In Example 42, the subject matter of Example 41 can optionally further include a flow control actuator configured to divert the flow of ablation material within the exhaust path.

[0078] In Example 43, the subject matter of any one of Examples 41-42 can optionally further include a sample reservoir coupled to the exhaust path, the sample reservoir configured to receive a sample of the ablation material in response to the flow control actuator diverting the flow of the ablation material.

[0079] In Example 44, the subject matter of any one of Examples 41-43 can optionally further include wherein the optical sensor includes a spectrometer.

[0080] In Example 45, the subject matter of any one of Examples 41-44 may optionally further include, wherein the controller is configured to provide a second signal representing the measurement information to the ultrasonic ablation energy source.

[0081] In Example 46, the subject matter of any one of Examples 41 to 45 may optionally further include, wherein the controller is configured to provide a second signal representing the measurement information to the laser ablation energy source.

[0082] Example 47 is a compositional identification system including a probe configured to extend through a working channel of an observation scope and configured to transmit mechanical energy to tissue of a patient to ablate the tissue at a distal end of the probe, an illumination source configured to illuminate at least a portion of the tissue, and a spectrometer configured to receive responsive illumination from at least a portion of the tissue to provide compositional information about at least a portion of the tissue.

[0083] In Example 48, the subject matter of Example 47 can optionally further include a first optical medium configured to transmit light from the illumination source to the distal end of the probe.

[0084] In Example 49, the subject matter of any one of Examples 47-48 can optionally further include the first optical medium extending with the probe through the working channel.

[0085] In Example 50, the subject matter of any one of Examples 47-49 can optionally further include a viewing device, the viewing device including a first optical medium.

[0086] In Example 51, the subject matter of any one of Examples 47 to 50 may optionally further include that the observation instrument includes a camera configured to receive the response illumination and to transmit the response illumination to the spectrometer via the first signal.

[0087] In Example 52, the subject matter of any one of Examples 47-51 can optionally further include a second optical medium configured to extend with the probe through the working channel, the second optical medium configured to transmit the illumination response to the spectrometer.

[0088] In Example 53, the subject matter of any one of Examples 47-52 can optionally further include an exhaust path configured to exhaust at least a portion of the tissue toward a collection system, the exhaust path including a channel of the probe.

[0089] In Example 54, the subject matter of any one of Examples 47-53 can optionally further include, in which the exhaust path includes an optically transparent portion disposed between the probe and the collection system.

[0090] In Example 55, the subject matter of any one of Examples 47-54 can optionally further include, wherein the illumination source is configured to illuminate at least a portion of the tissue with the transparent portion.

[0091] In Example 56, the subject matter of any one of Examples 47-55 can optionally further include, wherein the spectrometer is configured to receive the responsive illumination at the transparent portion.

[0092] In Example 57, the subject matter of any one of Examples 47-56 may optionally further include a flow control configured to modify a flow of at least a portion of the tissue in response to a signal received from a sensor upstream of the spectrometer.

[0093] In Example 58, the subject matter of any one of Examples 47-57 can optionally further include, wherein the flow control is configured to capture the portion as a sample in a sample chamber coupled to the exhaust path.

[0094] Example 59 is a method of operating a composition identification system, the method including the steps of mechanically ablating tissue via a probe extending through a working channel of an observation instrument, illuminating at least a portion of the tissue to provide responsive illumination, and generating a first signal based on the responsive illumination, the first signal including spectral analysis information about a composition of at least a portion of the tissue.

[0095] In Example 60, the subject matter of Example 59 can optionally further include, where the illuminating step includes illuminating at least a portion of the tissue via a first optical medium extending with the probe through the working channel.

[0096] In Example 61, the subject matter of any one of Examples 59 to 60 may optionally further include, in which the step of generating a first signal includes a step of relaying the illumination response to a spectrometer via a camera of the observation instrument.

[0097] In Example 62, the subject matter of any one of Examples 59 to 61 may optionally further include, wherein the step of generating a first signal includes a step of receiving the response illumination at a spectrometer via a second optical medium extending with the probe through the working channel.

[0098] In Example 63, the subject matter of any one of Examples 59-62 can optionally further include a step of discharging at least a portion of the tissue from the distal end of the probe toward a collection system via a discharge path, the discharge path including a channel of the probe.

[0099] In Example 64, the subject matter of any one of Examples 59 to 63 can optionally further include, wherein the illuminating step includes a step of illuminating at least a portion of the tissue through an optically transparent portion of the exhaust path, the optically transparent portion being disposed between the exhaust path and a proximal end of the collection system.

[0100] In Example 65, the subject matter of any one of Examples 59 to 64 may optionally further include that the step of generating a first signal based on the response illumination includes a step of receiving the illumination response with a spectrometer positioned adjacent to the transparent portion.

[0101] In Example 66, the subject matter of any one of Examples 59-65 may optionally further include modifying a flow of at least a portion of the tissue in response to a second signal received from a sensor upstream of the spectrometer.

[0102] In Example 67, the subject matter of any one of Examples 59-66 can optionally further include capturing at least a portion of the tissue as the sample in a sample chamber coupled to the exhaust path.

[0103] In Example 68, a system for analyzing and processing a biological sample can include an acoustic transmission probe that applies acoustic processing to a biological sample, the biological sample being located within a patient at a distal end of the probe, and an ejection system configured to eject a plurality of portions of the biological sample from a region near the distal end of the probe, the plurality of portions being fragmented from the biological sample in response to the acoustic processing. The ejection system can include an ejection path configured to move the plurality of portions to a terminal collection system, and a sample chamber configured to divert a first portion of the plurality of portions from the ejection path to provide a sample of the biological sample.

[0104] In Example 69, the system of Example 68 can optionally further include an illumination source configured to illuminate the sample in the sample chamber.

[0105] In Example 70, the system of any one of Examples 68-69 may optionally include an optical sensor system configured to generate spectral information based on response illumination received from the specimen in response to illumination provided by the illumination source.

[0106] In Example 71, the system of any one of Examples 68-70 is optionally a spectrometer configured to provide spectral information of the sample.

[0107] In Example 72, the system of any one or more of Examples 68-71 optionally includes a controller configured to receive the spectral information and to drive the acoustic transmission probe, the controller further configured to adjust parameters for driving the acoustic transmission probe in response to the spectral information.

[0108] Example 73 is at least one machine-readable medium including instructions that, when executed by a processing circuit, cause the processing circuit to perform operations implementing any of Examples 1-72.

[0109] Example 74 is an apparatus including means for implementing any of examples 1-72.

[0110] Example 75 is a system that implements any of Examples 1 to 72.

[0111] Example 76 is a method for implementing any of Examples 1-72.

[0112] The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments in which the invention may be practiced. These embodiments are also referred to herein as "examples." Such examples may include elements in addition to those shown or described. However, the inventors also contemplate examples in which only those elements shown or described are provided. The inventors also contemplate examples using any combination or permutation of those elements shown or described (or one or more aspects thereof), either with respect to a particular example (or one or more aspects thereof) or with respect to other examples (or one or more aspects thereof) shown or described herein.

[0113] In the event of a conflict in usage between this document and any document so incorporated by reference, the usage in this document will control.

[0114] The terms "a" or "an" are used herein to include one or more than one, as is common in patent documents, independent of any other instances or usages of "at least one" or "one or more." The term "or" is used herein to refer to non-exclusivity, or "A or B" to include "A but not B," "B but not A," and "A and B," unless otherwise indicated. The terms "including" and "in which" are used herein as the plain English equivalents of the terms "comprising" and "wherein," respectively. Also, the terms "including" and "comprising" are open-ended, i.e., a system, apparatus, article, composition, formula, or process that includes some elements in addition to those listed after such terms, would still be considered to be within the scope of the subject matter discussed. Also, as may appear in the claims, the terms "first," "second," "third," etc. are used merely as labels and are not intended to impose numerical requirements on these items.

[0115] The above description is intended to be illustrative and not restrictive. For example, the above examples (or one or more aspects thereof) can be used in combination with each other. Other embodiments can be used by those of ordinary skill in the art who have reviewed the above description, for example. The Abstract is provided to enable the reader to quickly ascertain the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above detailed description, various features may be grouped together to streamline the disclosure. This should not be construed as intending that an unclaimed disclosed feature is essential to any claim. Rather, the subject matter of the invention never lies in all features of a particular disclosed embodiment. The following aspects are incorporated herein as examples or embodiments into the detailed description, with each aspect standing on its own as a separate embodiment, and it is contemplated that such embodiments can be combined with each other in various combinations or permutations.

[0116] [Additional notes] [Additional note 1] 1. A system for analyzing and processing a biological sample in a patient, comprising: an acoustic transmission probe configured to extend through a working channel of a scope instrument and to acoustically process the biological sample at a distal end of the probe; an illumination light path configured to illuminate at least a portion of the biological sample; a response optical path configured to obtain an optical response signal from the at least a portion of the biological sample in response to the illumination; a spectrometer configured to analyze spectral information of the optical response signal to determine an indication of a composition of the at least a portion of the sample; Including, system. [Additional note 2] the illumination light path is configured to transmit light toward the distal end of the probe; Item 1. The system of claim 1. [Additional note 3] the illumination light path extends along the probe through the working channel of the scope instrument; Item 2. The system of claim 2. [Additional note 4] and a discharge path extending from the distal end of the probe and including a channel of the probe, the discharge path configured to discharge the at least a portion of the biological sample away from the distal end of the probe. Item 2. The system of claim 2. [Additional note 5] the discharge path is accessed by the illumination optical path and the response optical path to enable the illuminating, the acquiring of the optical response, and the analyzing to be performed on the at least a portion of the biological sample while the at least a portion of the biological sample is located in the discharge path; 5. The system according to claim 4. [Additional note 6] and a receptacle configured to receive the at least a portion of the biological sample from the discharge path, the receptacle being accessed by the illumination optical path and the response optical path to enable the illuminating, the acquiring of the optical response, and the analyzing to be performed on the at least a portion of the biological sample while the at least a portion of the sample is located in the receptacle. 5. The system according to claim 4. [Additional note 7] a controller circuit configured to at least one of establish or adjust discharge parameters in response to information including the indication of the composition of the analyzed at least a portion of the biological sample. 5. The system according to claim 4. [Additional note 8] and further comprising the observation scope instrument, the observation scope instrument including the illumination light path. Item 1. The system of claim 1. [Additional note 9] the observation instrument includes a camera configured to detect the optical response signal for transmission to the spectrometer. 9. The system according to claim 8. [Additional Note 10] at least one or both of the illumination path or the response optical path are coupled to the at least a portion of the biological sample via at least one optically transparent portion. Item 1. The system of claim 1. [Additional Note 11] the spectrometer is configured to receive the optical response signal through the transparent portion. Item 11. The system according to item 10. [Additional Note 12] and a controller circuit configured to at least one of establish or adjust acoustic processing parameters in response to information including the indication of the composition of the analyzed at least a portion of the biological sample. Item 1. The system of claim 1. [Additional Note 13] 1. An ablation instrument for ablating tissue, comprising: a probe having a distal end, the distal end being positioned proximate to the tissue, the distal end being configured to extend through a working channel of a scope; an exhaust path configured to pass a portion of the ablated tissue, a first portion of the exhaust path including the probe; a target identification system configured to optically sense a portion of the ablated tissue within the exhaust path, measure an aspect of the portion, and provide a first signal representative of the aspect; Including, Ablation instruments. [Additional Note 14] the exhaust path includes an optically transparent portion disposed between the proximal end of the probe and a collection system. Item 14. The ablation instrument according to claim 13. [Additional Note 15] the target identification system includes an illumination source directed at the optically transparent portion; the target identification system includes an optical sensor positioned opposite the illumination source relative to the transparent portion; the optical sensor is configured to generate the first signal; Item 15. The ablation instrument according to claim 14. [Additional Note 16] the target identification system includes a spectrometer configured to receive responsive illumination from the optically transparent portion and to generate the first signal. Item 15. The ablation instrument according to claim 14. [Additional Note 17] the ablation instrument further comprising a flow control; The flow control includes: receiving the first signal and altering flow of the portion of the ablated tissue in response to the first signal; and capturing the portion as a sample in a sample chamber coupled to the discharge path; It is configured as follows: Item 14. The ablation instrument according to claim 13. [Additional Note 18] 1. An apparatus for sensing an ablative material, comprising: an exhaust path configured to pass irrigation and ablation material from the ablation probe to a collection system; a light source configured to illuminate the irrigation and ablation material in the evacuation path; an optical sensor focused towards the exhaust path; a controller configured to receive a first signal from the optical sensor and provide measurement information about the ablation material based on the signal; Including, Device. [Additional Note 19] a flow control actuator configured to divert the flow of the ablation material within the exhaust path; a sample reservoir coupled to the exhaust path and configured to receive a sample of the ablation material in response to the flow control actuator diverting the flow of the ablation material; Further comprising: 19. The device according to claim 18. [Additional Note 20] The controller is configured to provide a second signal representative of the measurement information to at least one of an ultrasonic ablation energy source or a laser ablation energy source. 19. The device according to claim 18. [Additional Note 21] 1. A method of both analyzing a biological sample at a patient location during a medical procedure and also processing said biological sample at said patient location during the same medical procedure, comprising: acoustically processing the biological sample within the patient via an acoustic transmission probe extending through a working channel of a scope instrument and into the patient; illuminating at least a portion of the biological sample; obtaining an optical response signal in response to illuminating the at least a portion of the biological sample; analyzing the spectral information of the optical response signal at a location in the patient during the same medical procedure as the treatment to determine an indication of a composition of the at least a portion of the biological sample; Including, method. [Additional Note 22] wherein the step of illuminating at least a portion of the biological sample includes illuminating the at least a portion of the biological sample via a first optical path extending along the probe through the working channel of the scope instrument. 22. The method according to claim 21. [Additional Note 23] obtaining the optical response signal includes transmitting the optical response signal to a local spectrometer via a camera of the scope instrument; 23. The method according to claim 22. [Additional note 24] obtaining the optical response signal includes transmitting the optical response signal to a local spectrometer via a second optical path extending along the probe through the working channel of the scope instrument. 23. The method according to claim 22. [Additional note 25] ejecting at least a portion of the biological sample from a distal end of the probe via an ejection path that includes at least a portion of a longitudinal channel of the probe toward a local collection receptacle, wherein the steps of illuminating at least a portion of the sample, acquiring the optical response, and analyzing are performed on the at least a portion of the sample while the at least a portion of the sample is located in the local collection receptacle. 22. The method according to claim 21. [Additional note 26] Discharging the at least a portion of the biological sample from the distal end of the probe via a discharge path that includes at least a portion of the longitudinal channel of the probe. wherein the steps of illuminating at least a portion of the sample, acquiring the optical response, and analyzing are performed while the at least a portion of the biological sample is being discharged along the discharge path. 22. The method according to claim 21. [Additional note 27] at least one or both of the steps of illuminating at least a portion of the sample or acquiring the optical response are performed through at least one optically transparent portion disposed along the exhaust path. 27. The method according to claim 26. [Additional note 28] at least one of establishing or adjusting an output parameter in response to information including the indication of the composition of the analyzed at least a portion of the biological sample. 28. The method according to claim 27. [Additional note 29] establishing or adjusting acoustic processing parameters in response to information comprising the indication of the composition of the analyzed at least a portion of the biological sample. 29. The method according to claim 28. [Additional note 30] 1. A method of ablating tissue, comprising: applying energy to the tissue via a distal end of an ablation probe; exhausting a portion of the ablated tissue via an exhaust path, the exhaust path including a channel of the ablation probe; optically sensing the portion of the ablated tissue as the ablated tissue moves through the exhaust path; measuring said certain aspects; providing a first signal representative of said aspect; Including, method. [Additional note 31] receiving the first signal on a monitor and displaying the aspect; The method according to claim 30. [Additional note 32] applying the energy includes applying mechanical ablation energy to the tissue; The method includes receiving the first signal with a source of mechanical ablation energy and adjusting a characteristic of the mechanical ablation energy based on the first signal. The method according to claim 30. [Additional note 33] and optically sensing the portion includes directing illumination through an optically transparent portion of the exhaust path. The method according to claim 30. [Additional note 34] and optically sensing the portion includes directing illumination through an optically transparent portion of the exhaust path to an optical sensor. The method according to claim 33. [Additional note 35] the measuring step includes measuring the light intensity of the illumination with the optical sensor; The method according to claim 34. [Additional note 36] the first signal is based on the light intensity of the illumination; The method according to claim 35. [Additional note 37] the optically sensing step includes receiving responsive illumination from the transparent portion of the exhaust path with a spectrometer. The method according to claim 33. [Additional note 38] the measuring step includes measuring spectral information of the response illumination. The method according to claim 37. [Additional note 39] the first signal is based on the spectral information; The method according to claim 38. [Additional note 40] adjusting a flow of the ablated tissue through the exhaust path in response to the first signal. The method according to claim 30. [Additional note 41] and adjusting the flow includes capturing the portion in a sample chamber coupled to the exhaust path. 41. The method according to claim 40. [Additional note 42] a probe configured to extend through a working channel of a viewing scope and to deliver mechanical energy to tissue of a patient to ablate the tissue at a distal end of the probe; an illumination source configured to illuminate at least a portion of the tissue; a spectrometer configured to receive responsive illumination from the at least a portion of the tissue to provide compositional information about the at least a portion of the tissue; Includes Compositional Identification System. [Additional note 43] a first optical medium configured to transmit light from the illumination source to the distal end of the probe; 43. The composition identification system according to claim 42. [Additional note 44] the first optical medium extends through the working channel with the probe; 44. The composition identification system according to claim 43. [Additional note 45] The observation device includes the viewing instrument includes the first optical medium; 45. The composition identification system according to claim 44. [Additional note 46] the observation instrument includes a camera configured to receive the response illumination and to communicate the response illumination to the spectrometer via a first signal; 46. ​​The composition identification system according to claim 45. [Additional note 47] a second optical medium configured to extend with the probe through the working channel, the second optical medium configured to communicate the illumination response to the spectrometer. 44. The composition identification system according to claim 43. [Additional note 48] an exhaust path configured to exhaust the at least a portion of the tissue toward a collection system, the exhaust path including a channel of the probe. 43. The composition identification system according to claim 42. [Additional note 49] the exhaust path includes an optically transparent portion disposed between the probe and the collection system. Item 49. The composition identification system according to item 48. [Additional Note 50] the illumination source is configured to illuminate the at least a portion of the tissue at the transparent portion. 49. The composition identification system according to claim 49. [Additional note 51] the spectrometer is configured to receive the response illumination at the transparent portion. 51. The composition identification system according to claim 50. [Additional note 52] a flow control configured to modify flow of the at least a portion of the tissue in response to a signal received from a sensor upstream of the spectrometer. Item 49. The composition identification system according to item 48. [Additional note 53] the flow control is configured to capture the portion as a sample in a sample chamber coupled to the exhaust path. 53. The composition identification system according to claim 52. [Additional note 54] 1. A method of operating a composition identification system, comprising: mechanically ablating tissue via a probe extending through a working channel of the scope; providing responsive illumination to illuminate at least a portion of the tissue; generating a first signal based on the responsive illumination, the first signal comprising spectral analysis information about a composition of the at least a portion of the tissue; Including, method. [Additional note 55] the illuminating step includes illuminating the at least a portion of the tissue through a first optical medium extending with the probe through the working channel. 55. The method according to claim 54. [Additional note 56] generating the first signal includes relaying the illumination response via a camera of the viewing instrument to a spectrometer; 56. The method according to claim 55. [Additional note 57] generating the first signal includes receiving the response illumination at a spectrometer via a second optical medium extending with the probe through the working channel. 56. The method according to claim 55. [Additional note 58] evacuating at least a portion of the tissue from a distal end of the probe toward a collection system via an evacuation path, the evacuation path including a channel of the probe. 55. The method according to claim 54. [Additional note 59] the illuminating step includes illuminating the at least a portion of the tissue through an optically transparent portion of the exhaust path, the optically transparent portion being disposed between a proximal end of the probe and the collection system. 59. The method according to claim 58. [Additional note 60] generating a first signal based on the response illumination includes receiving the illumination response with a spectrometer disposed adjacent to the transparent portion; 59. The method according to claim 59. [Additional note 61] modifying flow of the at least a portion of the tissue in response to a second signal received from a sensor upstream of the spectrometer. 61. The method according to claim 60. [Additional note 62] capturing the at least a portion of the tissue as a sample in a sample chamber coupled to the discharge path. 62. The method according to claim 61. [Additional note 63] 1. A system for analyzing and processing a biological sample, comprising: an acoustic transmission probe for performing acoustic processing on the biological sample, the biological sample being located within a patient at a distal end of the probe; 11. An ejection system configured to eject a plurality of portions of the biological sample from a region near the distal end of the probe, the plurality of portions being fragmented from the biological sample in response to the acoustic treatment, the ejection system comprising: an exhaust path configured to move the plurality of portions to a terminal collection system; a specimen chamber configured to divert a first portion of the plurality of portions from the exhaust path to provide a specimen of the biological sample; an exhaust system including: Including, system. [Additional note 64] an illumination source configured to illuminate the sample in the sample chamber; Item 64. The system described in paragraph 63. [Additional note 65] an optical sensor system configured to generate spectral information based on response illumination received from the specimen in response to illumination provided by the illumination source; Item 65. The system described in paragraph 64. [Additional note 66] the optical sensor system is a spectrometer configured to provide spectral information of the sample. Item 66. The system described in paragraph 65. [Additional note 67] a controller configured to receive the spectral information and to drive the acoustic transmission probe, the controller further configured to adjust parameters for driving the acoustic transmission probe in response to the spectral information. Item 67. The system described in paragraph 66. [Explanation of symbols]

[0117] 100 Ablation System 102 Ablation Controller 103 Ablation Instruments 104 Ablation Probe 105 Working Channel 107 Observation Equipment 109 Mechanical Ablation Controller 111 Handle 113 Tube 114 Light path 130 Material Management System 145 Composition Detector 200 Mechanical Ablation System 204 Ablation Probe 205 Working Channel 206 Light source 207 Observation Equipment 208 Spectrometer 209 Mechanical Ablation Controller 210 Spectral Analyzer 211 Light path 212 Optical Sensor 217 Biological samples and specimens 219 Distal end 300 Mechanical Ablation System 304 Ablation Probe 305 Working Channel 306 First Light Source 307 Observation Equipment 308 Spectrometer 309 Mechanical Ablation Controller 310 Spectral Analyzer 311 Light path 312 Second optical path 312 Optical Sensor 317 Biological samples and specimens 319 Distal end 400 Mechanical Ablation System 404 Ablation Probe 405 Working Channel 406 Light source 407 Observation Equipment 408 Spectrometer 409 Mechanical Ablation Controller 410 Spectral Analyzer 411 Light path 412 Optical Sensor 414 Light path 417 Biological samples and specimens 419 Distal end 504 Ablation Probe 513 Tube 520 holes 521 Optical Fiber 604 Ablation Probe 613 Tube 621 Optical Fiber 622 Bonding materials 623 Sealant 704 Ablation Probe 713 Tube 720 holes 721 Optical Fiber 804 Ablation Probe 813 Tube 821 Optical Fiber 823 Channel 900 Mechanical Ablation System 904 Ablation Probe 906 light source 909 Mechanical Ablation Controller 910 Feedback Analyzer 911 Handle 912 Optical Sensor 917 stone 922 Stone fragment 930 Material Management System 931 Emission Route 932 Optical transparent part 935 Cloud 945 Composition Detector 1090 Relative Size 1100 Mechanical Ablation System 1103 Ablation instruments 1104 Ablation Probe 1106 Light source 1109 Ablation Controller 1111 Handle 1112 Optical Sensor System 1117 Biological materials 1122 Stone fragment 1131 Emission route 1136 Electronic Medical Record System 1145 Composition Detector 1222 Ablation materials, stone fragments 1231 Emission route 1241 Flow Control Actuator 1245 Composition Detector 1250 Collection Chamber

Claims

1. 1. A system for analyzing and processing a biological sample in a patient, comprising: an acoustic transmission probe configured to extend through a working channel of a scope instrument and to acoustically process the biological sample at a distal end of the probe; an illumination light path configured to illuminate at least a portion of the biological sample; a response optical path configured to obtain an optical response signal from the at least a portion of the biological sample in response to the illumination; a spectrometer configured to analyze spectral information of the optical response signal to determine an indication of a composition of the at least a portion of the sample; a controller circuit configured to at least one of establish or adjust acoustic processing parameters of acoustic processing of the acoustic transmission probe in response to information including the indication of the composition of the analyzed at least portion of the biological sample; Including, system.

2. The acoustic processing parameters include at least one of a drive signal shape, a frequency, an amplitude, a pulse width, or a pulse frequency of the acoustic processing of the acoustic transmission probe. The system of claim 1 .

3. The controller circuitry is configured to establish or adjust the acoustic processing parameters in real time based on the indication of the composition of the analyzed at least a portion of the biological sample. The system of claim 1 .

4. To determine the indication of the composition of the at least a portion of the biological sample, the spectrometer is configured to determine at least one of a size, a shape, a surface texture, a density, a hardness, or a color of the at least a portion of the biological sample. The system of claim 1 .

5. The acoustic transmission probe includes a tube, the illumination optical path and the response optical path are attached to the tube; The system of claim 1 .

6. The acoustic transmission probe includes a tube, the illumination optical path and the response optical path are each separately integrated with the tube; The system of claim 1 .

7. The acoustic transmission probe includes a tube, the illumination light path and the response light path extend along a portion of the tube and, at a distal end of the tube, follow a recess in the tube and transition to a hole in a sidewall of the tube; The system of claim 1 .

8. The acoustic transmission probe includes a tube, the illumination optical path and the response optical path are in recessed channels on and along an exterior surface of the tube; The system of claim 1 .

9. Further comprising the observation scope instrument, the observation scope instrument including the illumination light path; the illumination light path is configured to extend along the probe through the working channel of the scope instrument and transmit light toward the distal end of the probe; The system of claim 1 .

10. At least one or both of the illumination path or the response optical path are coupled to at least a portion of the biological sample via at least one optically transparent portion; the spectrometer is configured to receive the optical response signal through the optically transparent portion. The system of claim 1 .

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