In-situ laser spectroscopy for lithotripsy

Abstract

To provide a medical system, device, and method for performing laser lithotripsy on patients. [Solution] The medical device is configured to advance along the patient's urinary tract, and the system 100 further includes a console 110. The console includes one or more processors 160 and logic stored in memory 165. The logic, when executed by one or more processors, causes the system to perform the following actions: (i) project coherent light onto a kidney stone in the patient, away from the distal end; (ii) receive a reaction light signal emitted from the kidney stone in response to the coherent light; and (iii) process the reaction light signal to determine the material composition of the kidney stone. The system is also configured to project coherent light onto the kidney stone to induce fragmentation of the kidney stone, and the operation settings of the coherent light can be based on the determined composition of the kidney stone.

Description

Background Art

[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 can be adjusted for optimal fragmentation or ablation of the kidney stone. Optimal settings during laser lithotripsy can be advantageous in shortening the time required to perform the laser lithotripsy procedure and minimizing the risk of harming the patient, such as damaging healthy tissue.

[0002] The systems, devices, and methods disclosed herein may provide some of the aforementioned advantages by providing in-situ evaluation of kidney stone composition.

Summary of the Invention

[0003] Briefly summarized, the 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 elongate medical device having one or more optical fibers extending between a proximal end and a distal end, the elongate medical device being configured to advance along a patient's urinary tract. The system further includes 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 stores logic for causing the system to perform operations including: (i) projecting coherent light onto a kidney stone within the patient away from the distal end; (ii) receiving a reaction optical signal emitted from the kidney stone in response to the coherent light; and (iii) processing the reaction optical signal to determine the material composition of the kidney stone when executed by the one or more processors.

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

[0005] The coherent light and at least one of the reaction light signal may include multiple wavelengths. In some embodiments, the reaction light signal is at least partially formed by the reflection of the coherent light.

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

[0007] In some embodiments, the operation 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 spectral signature; and (iii) combining the spectral signature with the at least one spectral signature stored in memory in order to improve the accuracy of the at least one spectral signature stored in memory.

[0008] In some embodiments, the reaction light 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 reaction light signal.

[0009] In some embodiments, projecting the coherent light to cause fragmentation of the kidney stone is done according to an operating setting, the operating setting includes one or more of the pulse frequency, pulse duration, or wavelength of the coherent light. In further embodiments, at least one of the operating settings is defined at least in part on the determined material composition of the kidney stone.

[0010] Further described herein are methods implemented by medical systems, the methods comprising (i) transmitting coherent light along the patient's urinary tract, (ii) projecting coherent light onto a kidney stone located within the patient, (iii) receiving a reaction light signal emitted from the kidney stone in response to the coherent light, and (iv) processing the reaction light signal to determine the material composition of the kidney stone.

[0011] In some embodiments, the coherent light and / or at least one of the reaction light signal comprises a plurality of wavelengths. The reaction light signal may be formed at least partially by reflection of the coherent light.

[0012] In some embodiments of the method described above, processing the reaction light includes defining a spectral signature of the kidney stone based on the reaction light signal, the spectral signature comprising a plurality of wavelengths, each wavelength having a corresponding intensity.

[0013] In some embodiments, processing the reaction light signal includes (i) comparing the spectral signature with one or more spectral signatures stored in memory, wherein the spectral signatures stored in memory represent different material compositions of kidney stones, and (ii) determining the 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 spectral signature; and (iii) combining the spectral signature with the at least one spectral signature stored in memory in order to improve the accuracy of the at least one spectral signature stored in memory.

[0015] In some embodiments of the method described above, projecting the coherent light includes projecting the coherent light according to an operating setting configured to cause fragmentation of the kidney stone, the operating setting including one or more of the pulse frequency, pulse duration, or wavelength of the coherent light. At least one of the operating settings is defined at least in part on the determined material composition of the kidney stone.

[0016] In some embodiments of the method described above, the system includes a long medical device configured to advance along the urinary tract, the medical device including one or more optical fibers. The long medical device may be configured to advance along the working channel of a ureteroscope.

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

[0018] Such and other features of the concepts provided herein will become more apparent to those skilled in the art in consideration of the accompanying drawings and the following description, which disclose in more detail specific embodiments of such concepts.

[0019] Embodiments of the present disclosure are described in the drawings of the attached drawings as examples, not as limitations, and in the drawings, similar reference numerals indicate similar elements. [Brief explanation of the drawing]

[0020] [Figure 1] A diagram illustrating exemplary embodiments of a medical system, including a long medical device having an optical fiber extending along the medical device, according to several embodiments. [Figure 2] End views of the medical device shown in Figure 1, according to several embodiments. [Figure 3A] Figure 1 shows a medical device positioned within the working channel of a ureteroscope performing laser lithotripsy, according to several embodiments. [Figure 3B] Figure 1 shows a medical device positioned within the working channel of a ureteroscope used for laser spectroscopy, according to several embodiments. [Figure 4] An illustrative diagram showing spectral signatures according to several embodiments. [Figure 5] A flowchart illustrating the operation performed by the medical system shown in Figure 1, according to several embodiments. [Modes for carrying out the invention]

[0021] Before certain specific embodiments are disclosed in more detail, it should be understood that certain embodiments disclosed herein do not limit the scope of the concepts provided herein. It should also be understood that certain embodiments disclosed herein may have features that are easily separable from a particular embodiment and which, at their discretion, can be combined with or substituted for features of any of the many other embodiments disclosed herein.

[0022] Regarding the terms used in this specification, it should also be understood that the terms are for the purpose of describing some specific embodiments and do not limit the scope of the concepts provided in this specification. Ordinal numbers (e.g., first, second, third, etc.) are generally used to distinguish or identify different features or steps within a group of multiple features or multiple steps and do not provide a continuous limitation or numerical limitation. 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 does not necessarily have to be limited to three features or steps. Labels such as "left", "right", "up", "down", "front", "rear", etc. are used for convenience and do not, for example, mean a specific fixed position, orientation, or direction. Instead, such notations are used, for example, to reflect a relative position, orientation, or direction. The singular forms "a", "one", and "the" include plural references unless the context clearly dictates otherwise.

[0023] Regarding "proximal", for example, the "proximal portion" or "proximal end portion" of a stylet disclosed in this specification includes the portion of the stylet intended to be near the clinician when the stylet is used on a patient. Similarly, for example, the "proximal length" of a stylet includes the length of the stylet intended to be near the clinician when the stylet is used on a patient. For example, the "proximal end" of a stylet includes the end of the stylet intended to be near the clinician when the stylet is used on a patient. The proximal portion, proximal end portion, or proximal length of a stylet can include the proximal end of the stylet, but the proximal portion, proximal end portion, or proximal length of a stylet does not necessarily have to include the proximal end of the stylet. That is, unless suggested by the context, the proximal portion, proximal end portion, or proximal length of a stylet is not the distal portion or distal length of the stylet.

[0024] Regarding "distal", for example, the "distal portion" or "distal end portion" of the stylet disclosed in this specification includes the portion of the stylet that is intended to be near or within the patient when the stylet is used on the patient. Similarly, for example, the "distal length" of the stylet includes the length of the stylet that is intended to be near or within the patient when the stylet is used on the patient. For example, the "distal end" of the stylet includes the end of the stylet that is intended to be near the clinician or within the patient's body when the stylet is used on the patient. The distal portion, distal end portion, or distal length of the stylet can include the distal end of the stylet, but the distal portion, distal end portion, or distal length of the stylet does not necessarily have to include the distal end of the stylet. That is, except as suggested by the context, the distal portion, distal end portion, or distal length of the stylet is not the terminal portion or terminal length of the stylet.

[0025] The term "logic" can represent hardware, firmware, or software configured to perform one or more functions. As hardware, the term "logic" can refer to, or include, a circuit having data processing and / or storage capabilities. Examples of such circuits 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 memories, or combinatorial 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 in any type of suitable non-temporary storage medium, or temporary storage medium (e.g., electrical, optical, acoustic, or other forms of propagating signals such as carrier waves, infrared signals, or digital signals). Examples of non-temporary storage mediums include, but are not limited to, programmable circuits, volatile memory (e.g., any type of random-access memory "RAM"), or non-volatile memory (e.g., read-only memory "ROM", power-backed RAM, flash memory, phase-change memory, etc.), semiconductor drives, hard disk drives, optical disc 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 actions to carry out the described method. The steps and / or actions of a method may be substituted for one another. In other words, the order and / or use of a given step and / or action may be changed unless a given order of steps or actions is required for the proper operation of the embodiment.

[0028] Referring to Figure 1, exemplary embodiments of a laser lithotripsy system (system) 100 including a laser spectroscopy function are shown according to several embodiments. As shown, 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 use with an endoscope, such as a ureteroscope. System 100 may be employed for ablation or fragmentation of kidney stones according to the lithotripsy operating mode. Furthermore, system 100 may be used to determine the material composition of kidney stones according to the spectroscopy operating mode.

[0029] An exemplary embodiment of console 110 includes a processor 160, memory 165, a display 170, and optical logic 180, but it should be understood that console 110 can take one of various forms and may include additional components (e.g., power supply, ports, interfaces, etc.) that are not characteristic of the embodiments of this disclosure. An example of console 110 is shown in U.S. Patent 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-temporary computer-readable media) are included to control the functions of console 110 during operation. The display 170 may be a liquid crystal diode (LCD) display integrated into console 110 and employed as a user interface for displaying information to a clinician, particularly during catheterization procedures (e.g., cardiac catheterization). In another embodiment, the display 170 may be separate from console 110. Although not shown, console 110 may include a user interface configured to provide user control of console 110. Such a user interface may be a graphical user interface integrated with the display 170.

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

[0031] Memory 165 includes a data repository 166, lithotomy logic 167, and spectroscopic logic 168. In some embodiments, the spectroscopic logic 168 may further include machine learning logic 169. The lithotomy logic 167 can define and control the operation of system 100 for performing lithotomy operations of system 100, and the spectroscopic logic 168 defines and control the operation of system 100 for determining the material composition of kidney stones, as will be further described 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 the probe assembly 119 and the reception of optical signal information from the probe assembly 119.

[0033] As shown in the figure, both the light source 182 and the optical receiver 184 are operably connected to a processor 160 that manages their operation. The optical receiver 184 is also operably coupled to provide reaction light data to a data repository 166 for storage and processing by the spectroscopic logic 168.

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

[0035] The stylet 120 is configured to be inserted into the urinary tract of the patient's body. Thus, the stylet 120 defines a length 123 extending between the activation controller 126 at the proximal end 121 and the distal tip 127, such that the length 123 is sufficient to extend from a location outside the patient to a location within the patient's kidney. As described above, the stylet 120 may also be inserted into the working channel of a ureteroscope (see Figures 3A and 3B), and therefore, the stylet 120 may be sized for insertion into the working channel of the ureteroscope and for advancement along the working channel. 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, it is possible to provide fluid flow through the working channel while the stylet 120 is positioned within the working channel.

[0036] According to one embodiment of the present disclosure, a startup control 126 included on the probe assembly 119 defines the operating mode of the system 100 and may be used by a clinician to selectively change 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 engaged for laser lithotomy 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 multicore optical fiber core 135 extending along the length 123 of the stylet 120 to a distal tip 127. The multicore optical fiber core 135 includes one or more core fibers 137. The core fibers 137 may include one, two, three, four, five, 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 Figure 2) for performing laser lithography, a second subset 240 for facilitating the transmission of light 155 for laser spectroscopy, and a third subset 250 for facilitating the return transmission of the reaction light signal 150. In other embodiments, the core fiber 137 may not be divided into subsets; that is, any or all of the core fiber 137 may be used for at least one of performing laser lithography, transmitting light 155 for laser spectroscopy, and returning the reaction light 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 supplying light 155 to the first subset 230 and a second light source 182B for supplying 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 can provide light 155 in the form of non-coherent light to subset 230 to induce radiative emission in the laser optical fibers. One or more laser optical fibers of subset 230 can receive the light 155 individually or in one or more groups. In other embodiments, subset 230 may not include laser optical fibers. In such embodiments, the light source 182A may provide laser light (i.e., coherent light) to the core fiber 137 of subset 230. As illustrated and described, the light source 182A and the core fiber 137 of subset 230 can constitute a crushing 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 sweep laser, but other suitable light sources, including semi-coherent light sources, LED light sources, etc., may also be used in addition to the laser. In some embodiments, the light source 182B may include multiple coherent light sources that provide laser light at different wavelengths.

[0042] Figure 2 shows a distal end view of the stylet 120, showing the end views 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. As an example rather than an limitation, Figure 2 shows one embodiment of the arrangement of core fibers 137. In an exemplary embodiment, subset 230 is located in the center of the cross-section of the stylet 120, and subsets 240, 250 are distributed around subset 230.

[0043] Subset 230 is shown as containing multiple core fibers 137. However, as described above, in some embodiments, subset 230 may contain a single core fiber. Subset 230 shows tightly bundled core fibers. However, in other embodiments, the core fibers of subset 230 may be dispersed among the core fibers of subsets 240 and 250.

[0044] In the illustrated embodiment, subset 240 and subset 250 each contain three core fibers 137. However, as described above, subsets 240 and 250 may each contain 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, although the core fibers 137 in subsets 240 and 250 are shown to be evenly and alternately distributed, in other embodiments the core fibers 137 in subsets 240 and 250 may be unevenly distributed, including being randomly distributed.

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

[0046] Figure 3A shows the stylet 120 during the laser lithotripsy process. As shown, in some embodiments, the stylet 120 may be used in conjunction with an endoscope, such as a ureteroscope 310. In the illustrated embodiments, 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 positioned close to the kidney stone 302 and directed toward the kidney stone 302. In the illustrated embodiments, the stylet 120 is located within the working channel 315 of the ureteroscope 310. In some embodiments, the stylet 120 may be integrated with the ureteroscope 310 so that the working channel 315 is available for other instruments, such as a fragment retrieval tool. As shown, the laser beam 330 projected from the core fiber 137 of subset 230 strikes the kidney stone 302 to excise or fragment the kidney stone 302. In some embodiments, the laser light 330 may include a monochromatic beam having a wavelength of about 1900 nm (nanometers) to 2200 nm.

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

[0048] The reaction light signal 350 may include any light (or any electromagnetic radiation) emitted from the kidney stone 302 in response to the laser light 340 striking the kidney stone 302. For example, in some cases, the reaction light 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 reaction light signal 350 may include emission of light, such as fluorescence. In yet another example, the reaction light signal 350 may be a combination of reflection and emission of light. Similar to the laser light 340, the reaction light signal 350 may include multiple wavelengths, including discrete wavelengths.

[0049] The spectroscopic logic 175 is configured to determine the material composition of the kidney stone 302. Kidney stones can contain a variety of substances. Most kidney stones consist of calcium compounds. Some kidney stones consist of uric acid. Other kidney stones are struvite stones, which result from kidney or urinary tract infections. Yet another type of kidney stone consists of cystine. The composition of the kidney stone can indicate the optimal or preferred method of treatment or removal. For example, some kidney stones can be treated chemically, while others may require mechanical treatment, such as laser lithotripsy. Similarly, kidney stones of different compositions may be optimal with different defined operating settings of the lithotripsy laser. Therefore, determining the composition of the kidney stone in situ can be advantageous in defining the optimal process for removal.

[0050] The spectral logic 175 can define a spectral signature (signature) 360 (see Figure 4) based on the reaction light signal 350. The signature 360 ​​can generally include the intensity of light at different wavelengths. In other words, the reaction light signal 350 may include a first intensity at a first wavelength (or wavelength range), a second intensity at a second wavelength, and so on, across the defined spectrum.

[0051] The data repository 166 may contain multiple kidney stone signatures (i.e., spectroscopic signatures previously defined for various kidney stone types / compositions). The spectroscopic logic 175 can compare signature 360 ​​with kidney stone signatures stored in the data repository 166 and determine that signature 360 ​​matches one of the kidney stone signatures stored in the data repository 166. For example, the spectroscopic logic 175 can compare signature 360 ​​with a calcium kidney stone signature stored in the data repository 166 and determine that kidney stone 302 is a calcium kidney stone.

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

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

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

[0055] Furthermore, the composition of the kidney stone can provide input for laser lithotripsy, meaning that the operating settings for the lithotripsy laser can be defined based on the determined composition of the kidney stone. In other words, the lithotripsy logic 170 may define the operating settings for the laser optical fibers of subset 230 (lithotripsy laser) based on signature 360.

[0056] The aforementioned laser lithotripsy system method includes methods performed in the laser lithotripsy system. For example, the laser lithotripsy system method includes a non-transient CRM that stores logic causing the laser lithotripsy system to perform a set of actions consisting of actions for determining the composition of a kidney stone via laser spectroscopy and actions for performing laser lithotripsy via a lithotripsy laser setting based on or partially based on the determined composition of the kidney stone.

[0057] Figure 5 shows a method 500 performed by the logic of a system (i.e., lithotomy logic 170, spectroscopic logic 175, or a combination thereof) for removing or causing the fragmentation of a kidney stone. The system may project light (e.g., coherent light) along the urinary tract onto the kidney stone (or fragment of a kidney stone) placed in the patient (block 510). The system may project light having a defined wavelength or a plurality of defined wavelengths. Different wavelengths may be projected simultaneously or at different times. The light may be projected during the laser lithotomy process or separately from the laser lithotomy process.

[0058] The light may be transmitted along the stylet to a position close to the kidney stone. In some embodiments, projecting the light may involve activating one or more optical fiber lasers positioned along the stylet. In other embodiments, the light may originate from a laser in the system console and travel distally through one or more optical fibers positioned along the stylet.

[0059] The system may receive a reaction light signal emitted from the kidney stone in response to light projected onto the kidney stone (block 520). The reaction light signal may travel proximal to the console through one or more optical fibers of the stylet.

[0060] The logic may process the reaction light signal to define a spectral signature of the kidney stone or fragment (block 530). In some embodiments, the spectral signature consists of multiple light wavelengths, each having a corresponding light intensity.

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

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

[0063] The logic may activate one or more laser optical fibers to project lithotripsy laser light onto a kidney stone according to defined settings, in order to excise the kidney stone or cause it to fragment (block 570).

[0064] In some embodiments, steps 510-570 may be performed multiple times to adequately excise or fragment the kidney stone for removal. While several specific embodiments are disclosed herein, and these specific embodiments are disclosed in some degree of detail, they are not intended to limit the scope of the concepts provided herein. Further adaptations and / or modifications may be apparent to those skilled in the art, and these adaptations and / or modifications are also encompassed in broader embodiments. Thus, it is possible to carry out developments from specific embodiments disclosed herein without departing from the scope of the concepts provided herein.

Claims

1. It is a medical system, A long medical device having one or more optical fibers extending between a proximal and distal end, configured to advance along the patient's urinary tract, The console is connected to the elongated medical device at its proximal end. The console comprises one or more processors and a non-temporary computer-readable medium, and the non-temporary computer-readable medium, when executed by the one or more processors, Projecting coherent light onto a kidney stone in the patient, away from the distal end, Receiving a reaction light signal emitted from the kidney stone in response to the coherent light, To determine the material composition of the kidney stone, the reaction light signal is processed. A medical system that stores the logic for performing actions that include [specific actions].

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

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

4. The system according to any one of claims 1 to 3, wherein the coherent light is projected from a plurality of optical fibers.

5. The system according to any one of claims 1 to 4, wherein the one or more optical fibers include an optical fiber laser.

6. The system according to any one of claims 1 to 5, wherein the coherent light includes a plurality of wavelengths.

7. The system according to any one of claims 1 to 6, wherein the reaction light signal includes a plurality of wavelengths.

8. The system according to any one of claims 1 to 7, wherein the reaction light signal is at least partially formed by the reflection of the coherent light.

9. A system according to any one of claims 1 to 8, Processing the reaction light signal includes defining the spectral signature of the kidney stone based on the reaction light signal. The spectral signature comprises the plurality of wavelengths, each wavelength having a corresponding intensity, in a system.

10. The system according to claim 9, wherein processing the reaction light signal is: The spectral signature is compared with one or more spectral signatures stored in memory, wherein the spectral signatures stored in memory represent different material compositions of kidney stones. As a result of the comparison, the material composition of the kidney stone was determined. A system that includes this.

11. The system according to claim 9 or 10, wherein the operation further: Receiving input information, wherein the input information includes an independent compositional evaluation of the kidney stone after removal from the patient. Associating the aforementioned input information with the aforementioned spectral signature, To improve the accuracy of at least one spectral signature stored in memory, the spectral signature is combined with the at least one spectral signature stored in memory. A system that includes this.

12. The system according to any one of claims 1 to 11, wherein the reaction light signal is received through one or more of the optical fibers.

13. A system according to any one of claims 1 to 12, The coherent light projected from a first subset of optical fibers is configured to cause fragmentation of the kidney stone, A system in which the coherent light projected from a second subset of optical fibers is configured to induce the reaction light signal.

14. The system according to claim 13, wherein the projection of the coherent light to cause fragmentation of the kidney stone is performed according to an operating setting, the operating setting includes one or more of the pulse frequency, pulse duration, or wavelength of the coherent light.

15. The system according to claim 14, wherein at least one of the operation settings is defined at least in part on the determined material composition of the kidney stone.

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