In situ lithotripsy laser spectroscopy.

Abstract

Disclosed herein are medical systems, devices, and methods for performing laser lithotripsy on a patient. The medical system includes a medical device. The medical device has a plurality of optical fibers extending along the medical device. The medical device is configured to advance along the patient's urinary tract. The system further includes a console. The console includes one or more processors and logic stored in a memory. The logic, when executed by the one or more processors, causes operation of the system including: (i) projecting coherent light onto a kidney stone in the patient away from a distal end; (ii) receiving a response light signal emanating from the kidney stone in response to the coherent light; and (iii) processing the response light signal to determine a material composition of the kidney stone. The system is also configured to project coherent light onto the kidney stone to cause fragmentation of the kidney stone, and an operational setting of the coherent light can be based on the determined composition of the kidney stone.

Description

[Background technology]

[0001] Laser lithotripsy is an established method for removing kidney stones from patients. Different types of kidney stones are composed of different materials. Different materials may respond differently to laser lithotripsy, and more specifically to the operating settings of the lithotripsy laser. Therefore, it may be advantageous to evaluate the composition of the kidney stone before or during the laser lithotripsy procedure so that the settings of the lithotripsy laser may be adjusted for optimal fragmentation or ablation of the kidney stone. Optimal settings during laser lithotripsy may be advantageous to reduce the time required to perform the laser lithotripsy procedure and minimize the risk of harming the patient, such as damaging healthy tissue.

[0002] The systems, devices, and methods disclosed herein provide for in situ kidney stone composition assessment and therefore may provide some of the aforementioned advantages. Summary of the Invention

[0003] Briefly summarized, embodiments disclosed herein are directed to medical systems, devices, and methods for performing laser lithotripsy on a patient. According to some embodiments, the medical system includes an elongated medical device having one or more optical fibers extending between a proximal end and a distal end, the elongated medical device configured to advance along a urinary tract of a patient. The system further includes a console coupled to the elongated medical device at the proximal end, the console including one or more processors and a non-transitory computer readable medium storing logic that, when executed by the one or more processors, causes operation of the system including: (i) projecting coherent light away from the distal end onto a kidney stone in a patient; (ii) receiving a response light signal emitted from the kidney stone in response to the coherent light; and (iii) processing the response light signal to determine a material composition of the kidney stone.

[0004] In some embodiments, the elongate medical device is configured for advancement along a working channel of a ureteroscope. The projected coherent light may be configured to cause fragmentation of the kidney stone, and the coherent light may be projected from a plurality of optical fibers, hi some embodiments, one or more of the optical fibers include an optical fiber laser.

[0005] At least one of the coherent light and the responsive optical signal may include multiple wavelengths, hi some embodiments, the responsive optical signal is formed at least in part by reflection of the coherent light.

[0006] In some embodiments, processing the response light signal includes defining a spectroscopic signature of the kidney stone based on the response light signal. The spectroscopic signature can include the plurality of wavelengths, each wavelength having a corresponding intensity. Processing the response light signal can further include comparing the spectroscopic signature to one or more spectroscopic signatures stored in a memory, the spectroscopic signatures stored in a memory representing different material compositions of kidney stones, and determining a material composition of the kidney stone as a result of the comparison.

[0007] In some embodiments, the operations further include (i) receiving input information, the input information including an independent compositional assessment of the kidney stone after removal from the patient; (ii) associating the input information with the spectroscopic signature; and (iii) combining the spectroscopic signature with the at least one spectroscopic signature stored in memory to improve accuracy of the at least one spectroscopic signature stored in memory.

[0008] In some embodiments, the responsive optical signal is received through one or more of the optical fibers. In some embodiments, the coherent light projected from a first subset of optical fibers is configured to cause fragmentation of the kidney stone, and the coherent light projected from a second subset of optical fibers is configured to induce the responsive light signal.

[0009] In some embodiments, projecting the coherent light to cause fragmentation of the kidney stone is performed according to operational settings, the operational settings including one or more of a pulse frequency, a pulse duration, or a wavelength of the coherent light, hi further embodiments, at least one of the operational settings is defined based at least in part on the determined material composition of the kidney stone.

[0010] Further described herein is a method implemented by a medical system, the method including (i) transmitting coherent light along a urinary tract of a patient, (ii) projecting the coherent light onto a kidney stone located within the patient, (iii) receiving a response light signal emanating from the kidney stone in response to the coherent light, and (iv) processing the response light signal to determine a material composition of the kidney stone.

[0011] In some embodiments, at least one of the coherent light and / or the responsive optical signal comprises multiple wavelengths. The responsive optical signal may be formed at least in part by reflection of the coherent light.

[0012] In some embodiments of the method, processing the response light includes defining a spectroscopic signature of the kidney stone based on the response light signal, the spectroscopic signature including a plurality of wavelengths, each wavelength having a corresponding intensity.

[0013] In some embodiments, processing the response light signal includes (i) comparing the spectroscopic signature to one or more spectroscopic signatures stored in a memory, the spectroscopic signatures stored in a memory representing different material compositions of kidney stones, and (ii) determining a material composition of the kidney stone as a result of the comparison.

[0014] In some embodiments, the method further includes (i) receiving input information, the input information including an independent compositional assessment of the kidney stone after removal from the patient, (ii) associating the input information with the spectroscopic signature, and (iii) combining the spectroscopic signature with the at least one spectroscopic signature stored in memory to improve accuracy of the at least one spectroscopic signature stored in memory.

[0015] In some embodiments of the method, projecting the coherent light includes projecting the coherent light according to operational settings configured to cause fragmentation of the kidney stone, the operational settings including one or more of a pulse frequency, a pulse duration, or a wavelength of the coherent light, at least one of the operational settings being defined based at least in part on the determined material composition of the kidney stone.

[0016] In some embodiments of the method, the system includes an elongate medical device configured for advancement along the urinary tract, the medical device including one or more optical fibers. The elongate medical device may be configured for advancement along a working channel of a ureteroscope.

[0017] In some embodiments, at least one optical fiber includes an optical fiber laser, and in further embodiments, the responsive optical signal is received through one or more of the optical fibers.

[0018] These and other features of the concepts provided herein will become more apparent to those of ordinary skill in the art in view of the accompanying drawings and following description, which disclose in more detail certain embodiments of such concepts.

[0019] Embodiments of the present disclosure are illustrated by way of example, and not by way of limitation, in the figures of the accompanying drawings in which like reference symbols refer to similar elements and in which: [Brief description of the drawings]

[0020] [Figure 1] 1 illustrates an exemplary embodiment of a medical system including an elongated medical device having optical fibers extending along the medical device, according to some embodiments. [Diagram 2] 2 is an end view of the medical device of FIG. 1 according to some embodiments. [Figure 3A] 2 illustrates the medical device of FIG. 1 positioned within a working channel of a ureteroscope performing a laser lithotripsy procedure, in accordance with some embodiments. [Figure 3B] 2 illustrates the medical device of FIG. 1 positioned within a working channel of a ureteroscope to perform a laser spectroscopy procedure, in accordance with some embodiments. [Figure 4] 1 is an exemplary diagram illustrating a spectroscopic signature according to some embodiments. [Diagram 5] 2 is a flowchart illustrating methods of operations performed by the medical system of FIG. 1 in accordance with some embodiments. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0021] Before some specific embodiments are disclosed in more detail, it should be understood that the specific embodiments disclosed herein do not limit the scope of the concepts provided herein. It should also be understood that the specific embodiments disclosed herein can have features that can be easily separated from the specific embodiment and, optionally, combined with or substituted for features of any of the other numerous embodiments disclosed herein.

[0022] With regard to the terms used herein, it should also be understood that the terms are intended to describe some particular embodiments, and that the terms do not limit the scope of the concepts provided herein. Ordinal numbers (e.g., first, second, third, etc.) are generally used to distinguish or identify different features or steps within a group of features or steps, and do not provide sequential or numerical limitations. For example, the "first", "second", and "third" features or steps do not necessarily have to appear in that order, and a particular embodiment including such features or steps is not necessarily limited to three features or steps. Labels such as "left", "right", "upper", "lower", "front", "rear", etc. are used for convenience and do not imply, for example, a particular fixed position, orientation, or direction. Instead, such designations are used to reflect, for example, a relative position, orientation, or direction. The singular forms "one", "one", and "said" also include plural references unless the context clearly dictates otherwise.

[0023] With respect to "proximal," for example, a "proximal portion" or "proximal end portion" of a stylet disclosed herein includes the portion of the stylet that is intended to be near the clinician when the stylet is used on a patient. Similarly, for example, a "proximal length" of a stylet includes the length of the stylet that is intended to be near the clinician when the stylet is used on a patient. For example, a "proximal end" of a stylet includes the end of the stylet that is intended to be near the clinician when the stylet is used on a patient. Although a proximal portion, proximal end portion, or proximal length of a stylet can include the proximal end of the stylet, a proximal portion, proximal end portion, or proximal length of a stylet need not include the proximal end of the stylet. That is, unless otherwise indicated by context, a proximal portion, proximal end portion, or proximal length of a stylet is not a terminal portion or terminal length of a stylet.

[0024] With respect to "distal," for example, a "distal portion" or "distal end portion" of a stylet disclosed herein includes a portion of the stylet that is intended to be near or within a patient when the stylet is used with a patient. Similarly, for example, a "distal length" of a stylet includes a length of the stylet that is intended to be near or within a patient when the stylet is used with a patient. For example, a "distal end" of a stylet includes an end of the stylet that is intended to be near a clinician or within a patient when the stylet is used with a patient. Although a distal portion, distal end portion, or distal length of a stylet can include the distal end of the stylet, a distal portion, distal end portion, or distal length of a stylet need not include the distal end of the stylet. That is, unless otherwise indicated by context, a distal portion, distal end portion, or distal length of a stylet is not a terminal portion or terminal length of a stylet.

[0025] The term "logic" may refer to hardware, firmware, or software configured to perform one or more functions. As hardware, the term logic may refer to or include circuitry having data processing and / or storage capabilities. Examples of such circuitry include, but are not limited to, hardware processors (e.g., microprocessors, one or more processor cores, digital signal processors, programmable gate arrays, microcontrollers, application specific integrated circuits "ASICs," etc.), semiconductor memory, or combinational elements.

[0026] Additionally or alternatively, the term logic may refer to or include software such as one or more processes, one or more instances, application programming interfaces (APIs), subroutines, functions, applets, servlets, routines, source code, object code, shared libraries / dynamic link libraries (DLLs), or one or more instructions. This software may be stored on any type of suitable non-transitory or transitory storage medium (e.g., electrical, optical, acoustic, or other forms of propagated signals, such as carrier waves, infrared signals, or digital signals). Examples of non-transitory storage media include, but are not limited to, non-transitory storage such as programmable circuits, volatile memory (e.g., any type of random access memory "RAM"), or transitory storage such as non-volatile memory (e.g., read only memory "ROM", power backed RAM, flash memory, phase change memory, etc.), solid state drives, hard disk drives, optical disk drives, or portable memory devices. As firmware, logic may be stored in persistent storage.

[0027] Any method disclosed herein includes one or more steps or acts of carrying out the described method. The steps and / or acts of the method may be interchanged with one another. In other words, the order and / or use of certain steps and / or acts may be modified unless a certain order of steps or acts is required for proper operation of an embodiment.

[0028] Referring to FIG. 1, an exemplary embodiment of a laser lithotripsy system (system) 100 including laser spectroscopy capabilities is shown, according to some embodiments. As shown, the system 100 generally includes a console 110 and a probe assembly 119 communicatively coupled to the console 110. The laser lithotripsy system 100 may be configured for utilization with an endoscope, such as a ureteroscope. The system 100 may be employed for ablation or fragmentation of kidney stones according to a lithotripsy mode of operation. Additionally, the system 100 may be used to determine the material composition of kidney stones according to a spectroscopy mode of operation.

[0029] An exemplary implementation of the console 110 includes a processor 160, a memory 165, a display 170, and optical logic 180, although it should be understood that the console 110 may take one of a variety of forms and may include additional components (e.g., power sources, ports, interfaces, etc.) that are not characteristic of aspects of the present disclosure. An example of the console 110 is shown in U.S. Pat. No. 10,992,078, the entire contents of which are incorporated herein by reference. One or more processors 160 with access to memory 165 (e.g., non-volatile memory or non-transitory computer-readable media) are included to control the functions of the console 110 during operation. The display 170 may be a liquid crystal diode (LCD) display integrated into the console 110 and employed as a user interface, particularly for displaying information to a clinician during a catheterization procedure (e.g., cardiac catheterization). In another embodiment, the display 170 may be separate from the console 110. Although not shown, the console 110 may include a user interface configured to provide user control of the console 110. Such a user interface may be a graphical user interface integral to the display 170 .

[0030] According to some embodiments, the content shown by display 170 may change according to which mode the probe 120 is configured to operate in, i.e., lithotripsy or spectroscopy. In lithotripsy mode, the content rendered by display 170 may constitute settings or operating conditions of the probe assembly 119. In spectroscopy mode, the content rendered by display 170 may constitute kidney stone composition information.

[0031] Memory 165 includes a data repository 166, lithotripsy logic 167, and spectroscopy logic 168. In some embodiments, spectroscopy logic 168 may further include machine learning logic 169. Lithotripsy logic 167 may define and control operation of system 100 for performing lithotripsy operations of system 100, and spectroscopy logic 168 defines and controls operation of system 100 for determining the material composition of kidney stones, as described further below.

[0032] The optical logic 180 is configured to support the optical operability of the probe assembly 119. The optical logic 180 defines and controls the delivery of light to and the reception of optical signal information from the probe assembly 119.

[0033] As shown, both the light source 182 and the light receiver 184 are operatively connected to the processor 160 which manages their operation. The light receiver 184 is also operatively coupled to provide the response light data to the data repository 166 for storage and processing by the spectroscopy logic 168.

[0034] According to one embodiment, the probe assembly 119 includes an elongated probe (e.g., stylet) 120 extending along a distal portion 122 of the probe assembly 119. A proximal portion 124 of the probe assembly 119 includes a console connector 133 at a proximal end of the probe assembly 119. The console connector 133 is optically coupled to a connector 146 disposed at a distal end of an interconnect 145 such that the probe assembly 119 is operatively connected to the console 110 via a number of optical fibers 147 extending along the interconnect 145. The optical fibers 147 facilitate the transmission of light 155 from the light source 182 and the return of reflected optical signals 150 to the console 110. Because the interconnect 145 may be flexible and relatively long (e.g., approximately 2-10 feet (0.6-3.0 meters) in length), the console 110 may be conveniently located away from the patient.

[0035] The stylet 120 is configured to be inserted into the urinary tract of a patient's body. Thus, the stylet 120 defines a length 123 extending between an actuation controller 126 at a proximal end 121 of the stylet 120 and a distal tip 127, the length 123 being sufficient to extend from a location outside the patient to a location within the patient's kidney. As described above, the stylet 120 may be inserted into a working channel of a ureteroscope (see FIGS. 3A, 3B), and thus the stylet 120 may be sized for insertion into and advancement along the working channel of the ureteroscope. More specifically, the length 123 may exceed the length of the ureteroscope, and the cross-sectional diameter of the stylet 120 may be sized for insertion into the working channel, i.e., less than the diameter of the working channel. In some embodiments, the cross-sectional diameter of the stylet 120 may be substantially smaller than the inner diameter of the working channel of the ureteroscope. Because the diameter of the stylet 120 is relatively small compared to the inner diameter of the working channel, fluid flow through the working channel can be provided with the stylet 120 disposed within the working channel.

[0036] According to one embodiment of the present disclosure, activation controls 126 included on the probe assembly 119 define the operational mode of the system 100 and may be used by a clinician to selectively alter the operability of the display 170. For example, based on the mode of the system 100, the display 170 of the console 110 may be employed for laser lithotripsy or laser spectroscopy. In one embodiment, information from both modes may be displayed simultaneously (e.g., at least partially overlapping in time).

[0037] In some embodiments, the stylet 120 may include a multi-core optical fiber core 135 that extends along the length 123 of the stylet 120 to the distal tip 127. The multi-core optical fiber core 135 includes one or more core fibers 137. The core fibers 137 may include 1, 2, 3, 4, 5, or more core fibers 137. In some embodiments, the core fibers 137 may include up to 10, 20, 30, or more core fibers 137.

[0038] In the illustrated embodiment, the core fiber 137 may be divided into subsets. For example, the core fiber 137 may include a first subset 230 (see FIG. 2) for performing laser lithotripsy, a second subset 240 for facilitating transmission of light 155 for performing laser spectroscopy, and a third subset 250 for facilitating return transmission of the reaction optical signal 150. In other embodiments, the core fiber 137 may not be divided into subsets, i.e., any or all of the core fiber 137 may be utilized for at least one of performing laser lithotripsy, transmitting light 155 for laser spectroscopy, and returning the reaction optical signal 150.

[0039] The light source 182 may include separate light sources for the core fibers 137 of the first subset 230 and the core fibers 137 of the second subset 240. According to one embodiment, the light source 182 includes a light source 182A for providing light 155 to the first subset 230 and a second light source 182B for providing light 155 to the second subset 240.

[0040] In some embodiments, the first subset 230 may include one or more laser optical fibers. Thus, the light source 182A may provide light 155 in the form of non-coherent light to the subset 230 to stimulate radiative emission in the laser optical fibers. The one or more laser optical fibers of the subset 230 may receive the light 155 individually or in one or more groups. In other embodiments, the subset 230 may not include a laser optical fiber. In such an embodiment, the light source 182A may provide laser light (i.e., coherent light) to the core fiber 137 of the subset 230. As shown and described, the light source 182A and the core fiber 137 of the subset 230 may constitute a lithotripsy laser.

[0041] The second subset 240 may include a core fiber suitable for transmitting coherent light along the stylet 120. Thus, the light source 182B may include a coherent light source. The light source 182B may include any suitable type of coherent light source. The light source 182B may be a tunable swept laser, although other suitable light sources may be used in addition to lasers, including semi-coherent light sources, LED light sources, and the like. In some embodiments, the light source 182B may include multiple coherent light sources providing laser light at different wavelengths.

[0042] 2 illustrates a distal end view of stylet 120 showing an end view of each of the core fibers 137. As shown, the core fibers 137 may form a bundle of core fibers. In some embodiments, the core fibers 137 may define a particular arrangement. By way of example and not limitation, FIG. 2 illustrates one embodiment of an arrangement of the core fibers 137. In an exemplary embodiment, subset 230 is centrally located within a cross-section of stylet 120, and subsets 240, 250 are distributed around subset 230.

[0043] Subset 230 is shown as including multiple core fibers 137. However, as noted above, subset 230 may include a single core fiber in some embodiments. Subset 230 shows tightly packed core fibers. However, in other embodiments, the core fibers of subset 230 may be distributed among the core fibers of subsets 240, 250.

[0044] In the illustrated embodiment, subsets 240 and 250 each include three core fibers 137. However, as discussed above, subsets 240, 250 may each include one, two, four, or more core fibers 137, and the number of core fibers 137 in subset 240 may be the same as or different from the number of core fibers 137 in subset 250. Similarly, while the core fibers 137 in subsets 240, 250 are shown as being evenly distributed in an alternating fashion, in other embodiments, the core fibers 137 in subsets 240, 250 may be unequally distributed, including randomly distributed.

[0045] In some embodiments, the stylet 120 may include a cladding 215 disposed between the core fibers 137, and the stylet 120 may also include a sheath 210 extending around the core fibers 137 and along the length 123 of the stylet 120.

[0046] 3A illustrates the stylet 120 during a laser lithotripsy process. As shown, in some embodiments, the stylet 120 may be employed with an endoscope, such as a ureteroscope 310. In the illustrated embodiment, the stylet 120 is inserted into the urinary tract 303 extending toward the kidney stone 302 such that the distal tip 127 of the stylet 120 is located proximate to and points toward the kidney stone 302. In the illustrated embodiment, the stylet 120 is positioned within the working channel 315 of the ureteroscope 310. In some embodiments, the stylet 120 may be integral with the ureteroscope 310 such that the working channel 315 is available for other instruments, such as a fragment retrieval tool. As shown, laser light 330 projected from the core fiber 137 of the subset 230 impinges on the kidney stone 302 to ablate or fragment the kidney stone 302. In some embodiments, the laser light 330 may include a monochromatic beam having a wavelength between about 1900 nm (nanometers) and 2200 nm.

[0047] 3B shows the stylet 120 during the laser spectroscopy process. During the laser spectroscopy process, the laser light 340 is projected onto the kidney stone 302 from the core fibers 137 of the subset 240. The laser light 340 causes a response light signal 350 to emanate from the kidney stone 302 and be received by the core fibers 137 of the subset 250. The laser light 340 includes light of different wavelengths. The laser light 340 may include discrete wavelengths or wavelengths extending across a continuous spectrum. In some embodiments, the laser light 340 may include a monochromatic beam having a wavelength of about 1900 nm to 2200 nm. In some embodiments, the laser light 340 may include the laser light 330. Thus, the laser light 340 and the subset 240 of the core fibers 137 may be omitted.

[0048] The responsive optical signal 350 may include any light (or any electromagnetic radiation) emanating from the kidney stone 302 in response to the laser light 340 impinging on the kidney stone 302. For example, in some cases, the responsive optical signal 350 may include reflection or scattering of the laser light 340, such as Raman scattering. In some embodiments, the laser spectroscopy process may employ a Raman spectroscopy process. In other embodiments, the responsive optical signal 350 may include an emission of light, such as fluorescence. In yet other examples, the responsive optical signal 350 may be a combination of reflection and emission of light. Similar to the laser light 340, the responsive optical signal 350 may include multiple wavelengths, including discrete wavelengths.

[0049] The spectroscopy logic 175 is configured to determine the material composition of the kidney stone 302. Kidney stones may include a variety of materials. Most kidney stones are composed of calcium compounds. Some kidney stones are composed of uric acid. Other kidney stones are struvite stones that result from kidney or urinary tract infections. Still other kidney stones are composed of cystine. The composition of the kidney stone may indicate an optimal or preferred method of treatment or removal. For example, some kidney stones may be treated chemically while others may require mechanical treatment, such as laser lithotripsy. Similarly, kidney stones of different compositions may be optimal at different defined operating settings of the lithotripsy laser. Thus, determining the kidney composition in situ may be advantageous in defining an optimal process for removal.

[0050] The spectroscopic logic 175 can define a spectroscopic signature (signature) 360 (see FIG. 4) based on the responsive light signal 350. The signature 360 ​​can generally include intensities of light at different wavelengths. In other words, the responsive light signal 350 can include a first intensity at a first wavelength (or range of wavelengths), a second intensity at a second wavelength, etc. across a defined spectrum.

[0051] The data repository 166 may include multiple kidney stone signatures (i.e., spectroscopic signatures previously defined for various kidney stone types / compositions). The spectroscopy logic 175 may compare the signature 360 ​​to the kidney stone signatures stored in the data repository 166, and as a result of the comparison, determine that the signature 360 ​​corresponds (i.e., matches) with one of the kidney stone signatures stored in the data repository 166. As an example, the spectroscopy logic 175 may compare the signature 360 ​​to the calcium kidney stone signatures stored in the data repository 166, and as a result of the comparison, the spectroscopy logic 175 may determine that the kidney stone 302 is a calcium kidney stone.

[0052] 4 is an exemplary bar graph illustrating a comparison of the signature 360 ​​with a kidney stone signature 410 stored in a data repository. The wavelength spectrum extends along the x-axis and the y-axis represents light intensity. As shown, each of the wavelengths includes an intensity. In some embodiments, the comparison may consist of comparing the intensity of each wavelength of the signature 360 ​​to determine whether the intensity of each wavelength matches (e.g., is within a defined tolerance range of) the corresponding intensity of the kidney stone signature 410. If the corresponding intensities match, the spectroscopy logic 175 may determine that the material composition of the kidney stone 302 matches the material composition of the kidney stone type represented by the kidney stone signature 410.

[0053] In some embodiments, the spectroscopy logic 175 can include machine learning logic 176. The machine learning logic 176 can record the signature 360 ​​as a reference signature. Upon removal of the kidney stone, the type or composition of the kidney stone can be independently determined via another spectroscopic or chemical process. The result of the independent determination can be input to the system and associated with the reference signature. The reference signature can then be combined with the corresponding signature stored in memory to increase the accuracy of the signature stored in memory. For example, the spectroscopy logic 175 can determine that the kidney stone in the patient is a calculus (i.e., a kidney stone formed of calcium) based on a comparison of the signature 360 ​​and the exemplary signature 410. The clinician can obtain an independent determination that the kidney stone is indeed a calculus after removal of the kidney stone and input the independent determination into the system. The machine learning logic 176 may then combine the signature 360 ​​(the reference signature) as a training data set with the signature 410 to adjust the signature 410 (i.e., the intensity of each wavelength) to define a more accurate signature 410.

[0054] The lithotripsy logic 170 is configured to define operation of the laser optical fibers of the subset 230 to perform laser lithotripsy on the kidney stone 302. Controlling the laser optical fibers 137 includes controlling the light source 182A. The controlling may include defining operational settings, such as, for example, a pulse frequency or pulse duration of the lithotripsy laser. The operational settings may also include utilizing any number of the laser optical fibers of the subset 230. Utilizing some but not all of the laser optical fibers of the subset 230 may reduce the laser power applied to the kidney stone.

[0055] Also, the composition of the kidney stone may provide an input for the laser lithotripsy treatment, i.e., the operational settings of the lithotripsy laser may be defined based on the determined composition of the kidney stone. In other words, the lithotripsy logic 170 may define the operational settings of the laser optical fiber of the subset 230 (lithotripsy laser) based on the signature 360.

[0056] The aforementioned laser lithotripsy system methods include methods implemented in a laser lithotripsy system, for example, a laser lithotripsy system method including a non-transitory CRM having stored therein logic that causes the laser lithotripsy system to perform a set of operations for determining a composition of the kidney stone via laser spectroscopy and performing laser lithotripsy via a lithotripsy laser setting based or in part on the determined composition of the kidney stone.

[0057] 5 illustrates a method 500 performed by the logic of the system (i.e., lithotripsy logic 170, spectroscopy logic 175, or a combination thereof) for ablating or causing the fragmentation of a kidney stone. The system may project light (e.g., coherent light) along the urinary tract onto a kidney stone (or kidney stone fragments) placed in a patient (block 510). The system may project light having a prescribed wavelength or multiple prescribed wavelengths. Different wavelengths may be projected simultaneously or at different times. Light may be projected during the laser lithotripsy process or separately from the laser lithotripsy process.

[0058] The light may be transmitted along the stylet to a location proximate the kidney stone. In some embodiments, projecting the light may include activating one or more fiber optic lasers disposed along the stylet. In other embodiments, the light may originate from a laser in the console of the system and pass distally through one or more optical fibers disposed along the stylet.

[0059] The system may receive a responsive light signal emanating from the kidney stone in response to the light projected onto the kidney stone (block 520). The responsive light signal may pass proximally through one or more optical fibers in the stylet to the console.

[0060] The logic may process the response light signals to define a spectroscopic signature of the kidney stone or fragments (Block 530). In some embodiments, the spectroscopic signature consists of multiple wavelengths of light, each wavelength having a corresponding light intensity.

[0061] The logic may compare the spectroscopic signature of the kidney stone to one or more spectroscopic signatures stored in the memory (block 540), where the spectroscopic signatures stored in the memory are representative of different types of kidney stones or kidney stones of different material compositions. As a result of the comparison, the logic may determine that the kidney stone is of a predetermined type or material composition (block 550).

[0062] The logic may define one or more operational settings for the laser lithotripsy light to be projected onto the kidney stone to ablate or cause fragmentation of the kidney stone (block 560). In some embodiments, the operational settings may include a wavelength, a pulse rate or frequency, and / or a pulse duration of the laser light. The operational settings may be defined based at least in part on the determined kidney stone type or material composition.

[0063] The logic may activate one or more laser optical fibers to project lithotripsy laser light onto the kidney stone according to defined settings to ablate or cause fragmentation of the kidney stone (block 570).

[0064] In some embodiments, steps 510-570 may be performed multiple times to sufficiently excise or fragment the kidney stone for removal. Although some specific embodiments have been disclosed herein, and those specific embodiments have been disclosed in some detail, those specific embodiments are not intended to limit the scope of the concepts provided herein. Further adaptations and / or modifications may become apparent to those skilled in the art, and are likewise encompassed in the broader aspects. Thus, departures from the specific embodiments disclosed herein may be made without departing from the scope of the concepts provided herein.

Claims

1. 1. A health care system comprising: an elongated medical device having one or more optical fibers extending between a proximal end and a distal end, the elongated medical device configured for advancement along a urinary tract of a patient; a console coupled to the elongate medical device at the proximal end; the console including one or more processors and a non-transitory computer-readable medium that, when executed by the one or more processors, projecting coherent light away from the distal end onto a kidney stone within a patient; receiving a responsive light signal emanating from the kidney stone in response to the coherent light; processing the response light signals to determine a material composition of the kidney stone; The logic that causes the device to perform the action, including The one or more optical fibers include an optical fiber laser.

2. The system of claim 1 , wherein the elongated medical device is configured to be advanced along a working channel of a ureteroscope.

3. The system of claim 1 or 2, wherein the projected coherent light is configured to cause fragmentation of the kidney stone.

4. The system of claim 1 , wherein the coherent light is projected from a plurality of optical fibers.

5. The system of claim 1 , wherein the coherent light comprises multiple wavelengths.

6. The system of claim 1 , wherein the responsive optical signal comprises multiple wavelengths.

7. The system of claim 1 , wherein the responsive optical signal is formed at least in part by reflection of the coherent light.

8. A system according to any one of claims 1 to 7, comprising: Processing the response light signal includes defining a spectroscopic signature of the kidney stone based on the response light signal; The spectral signature includes the plurality of wavelengths, each wavelength having a corresponding intensity.

9. 10. The system of claim 8, wherein processing the response light signal comprises: comparing the spectroscopic signature to one or more spectroscopic signatures stored in a memory, the spectroscopic signatures stored in the memory being indicative of different material compositions of kidney stones; determining a material composition of the kidney stone as a result of the comparison; and A system including:

10. 10. The system of claim 8 or 9, wherein the operation further comprises: receiving input information, the input information including an independent compositional assessment of the kidney stone after removal from the patient; Associating the input information with the spectroscopic signature; combining said spectroscopic signature with at least one spectroscopic signature stored in a memory to improve accuracy of said at least one spectroscopic signature stored in a memory; A system including:

11. The system of claim 1 , wherein the responsive optical signal is received through one or more of the optical fibers.

12. A system according to any one of claims 1 to 11, comprising: the coherent light projected from a first subset of optical fibers is configured to cause fragmentation of the kidney stone; The coherent light projected from a second subset of optical fibers is configured to induce the responsive light signal.

13. 13. The system of claim 12, wherein projecting the coherent light to cause fragmentation of the kidney stone is performed according to operational settings, the operational settings including one or more of a pulse frequency, a pulse duration, or a wavelength of the coherent light.

14. 14. The system of claim 13, wherein at least one of the operational settings is defined based at least in part on the determined material composition of the kidney stone.

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