Optical surgical system comprising an integrated beam splitter assembly

Abstract

Systems and methods for identifying a target in vivo during an optical surgical procedure are disclosed. An optical surgical system comprises an energy source to emit an electrosurgical or electromagnetic signal, an optical splitter unit, and a probe defining an optical path to pass the electrosurgical or electromagnetic signal to the target and an optical response signal from the target. The optical splitter unit includes an integrated splitter assembly comprising pre-arranged optical components, such as prisms, spatially registered to one another, and configured to split the electrosurgical or electromagnetic signal into a first signal portion directed to the optical path for irradiating the target, and a second signal portion to a power detector. The integrated splitter assembly can further redirect an aiming beam to the optical path, and redirect a portion of the optical return signal to a feedback analyzer to identify a target characteristic.

Description

Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02INTEGRATED BEAM SPLITTER ASSEMBLYPRIORITY CLAIM

[0001] This application claims the benefit of priority to U.S. Patent Application Serial No. 63 / 683,899 filed August 16, 2024, the contents of which are incorporated herein by reference.FIELD OF THE DISCLOSURE

[0002] This document relates generally to optical surgical systems and devices, and more particularly to a multi-purpose beam splitter in an endoscopic surgical system to redirect various optical signals for identification and feedback-controlled treatment of an anatomical target.BACKGROUND

[0003] Laser or plasma systems have been used for delivering surgical laser energy to various target treatment areas such as soft or hard tissue. Examples of the laser therapy include ablation, coagulation, vaporization, fragmentation, etc. In lithotripsy applications, laser has been used to break down calculi structures in kidney, gallbladder, ureter, among other stone-forming regions, or to ablate large calculi into smaller fragments.

[0004] Endoscopes are typically used to provide access to an internal location of a subject such that a physician is provided with visual access. An endoscope is normally inserted into a patient’s body, delivers light to a target (e.g., a target anatomy or object) being examined, and collects signal (e.g., light) reflected from the object. The reflected signal carries information about the object being examined. Some endoscopes include a working channel through which the operator can perform suction or pass instruments such as brushes, biopsy needles or forceps, or perform minimally invasive surgery to remove unwanted tissue or foreign objects from the body of the patient.

[0005] In certain conventional procedures employing electromagnetic energy, there is no way of identifying characteristics (e.g., a type, a material, a composition, a composition profile, a structure or hardness) of an anatomical target while executing the procedure. In some procedures, it can be difficult to identify whether a target is soft or hard tissue in vivo. Some surgical methodsDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 involve extracting tissue and identifying tissue composition among other characteristics once it has been removed from the body. However, such characteristics usually cannot be determined in vivo.SUMMARY

[0006] Continuous identification of target characteristics during an endoscopic procedure can provide physicians with more information to help them titrate treatment strategies during the procedure. However, conventional tissue characterization techniques, which typically requires removal of tissue sample for analysis, are generally not feasible for continuous monitoring and identification of target characteristics throughout a procedure.

[0007] This document provides improved systems, methods, and apparatus for continuous, in vivo target monitoring and identification during procedure. In one aspect of the present disclosure, an optical surgical system comprises an energy source to emit an electrosurgical or electromagnetic signal (e.g., a treatment laser beam) to irradiate an anatomical target such as a tissue target or a calculi target, an aiming source to generate an optical aiming signal for targeting the anatomical target and assisting in positioning the electrosurgical or electromagnetic signal at a desired location on the anatomical targe, a probe defining an optical path to pass the electrosurgical or electromagnetic signal and the optical aiming signal to the anatomical target, and to pass an optical response signal from the anatomical target in response to illumination thereof, and an optical splitter unit coupled to the energy source, the aiming source, and the probe. The optical splitter unit can include a single multi-purpose splitter to split the electrosurgical or electromagnetic signal into at least first and second signal portions, and pass the first signal portion through the optical splitter unit and the optical path of the probe, redirect the optical aiming signal to the optical path of the probe, and redirect at least a portion of the optical return signal to a feedback analyzer for identifying a characteristic of the anatomical target. The single multi-purpose splitter may further redirect the second signal portion to a power detector to measure the power of the electrosurgical or electromagnetic signal.

[0008] In another aspect of the present disclosure, an optical surgical system comprises an energy source to generate an electrosurgical or electromagnetic signal (e.g., a treatment laser beam) to irradiate a target such asDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 a tissue target or a calculi target, a probe defining an optical path to pass the electrosurgical or electromagnetic signal to the anatomical target, and an optical response signal from the anatomical target in response to illumination thereof, and an optical splitter unit coupled between the energy source and the probe. The optical splitter unit can include an integrated splitter assembly comprising a plurality of pre-arranged optical components spatially registered to one another, such as pre-arranged optical prisms, configured to split the electrosurgical or electromagnetic signal into at least first and second signal portions, and pass the first signal portion through the optical splitter unit and the optical path of the probe, and refract and / or reflect at least a portion of the optical return signal toward a feedback analyzer for identifying a characteristic of the anatomical target. The integrated splitter assembly may further redirect the second portion of the electrosurgical or electromagnetic signal to a power detector to measure the power of the electrosurgical or electromagnetic signal, and / or to redirect an optical aiming signal to the optical path for targeting the anatomical target and assisting in positioning the electrosurgical or electromagnetic signal at the anatomical target.

[0009] In yet another aspect of the present disclosure, an optical surgical system, such as any of the those mentioned above that includes a single multipurpose splitter or an integrated splitter assembly (such as a prism assembly), further comprises one or more parabolic reflectors each having a concave surface to reflect and converge the light incident thereon. A first parabolic reflector can assist in redirecting at least a portion of the optical return signal to the feedback analyzer, in addition or alternative to a second parabolic reflector to assist in further redirecting the second portion of the electrosurgical or electromagnetic signal, redirected by the single multi-purpose splitter or the integrated splitter assembly, to the power detector.

[0010] Example 1 is an optical surgical system, comprising: a light source configured to generate illumination on an anatomical target; an energy source configured to generate an electrosurgical or electromagnetic signal to irradiate the anatomical target; a probe defining an optical path configured to pass (i) the electrosurgical or electromagnetic signal to the anatomical target, and (ii) an optical response signal from the anatomical target in response to illumination thereof; and an optical splitter unit coupled between the energyDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 source and the probe, the optical splitter unit including an integrated splitter assembly comprising a plurality of pre-arranged optical components spatially registered to one another, the integrated splitter assembly configured to: split the electrosurgical or electromagnetic signal into at least first and second signal portions, and pass the first signal portion through the optical splitter unit and the optical path of the probe; and refract and / or reflect at least a portion of the optical response signal toward a feedback analyzer for identifying a characteristic of the anatomical target.

[0011] In Example 2, the subject matter of Example 1 optionally includes the integrated splitter assembly that can comprise a plurality of prearranged optical prisms spatially registered to one another such that each of the plurality of pre-arranged optical prisms has a flat angled surface portion interfacing with and conforming to a flat angled surface portion of another of the plurality of pre-arranged optical prisms.

[0012] In Example 3, the subject matter of Example 2 optionally includes the plurality of pre-arranged optical prisms that can include first and second optical prisms, the first optical prism more proximally positioned to the energy source than the second optical prism, wherein the second optical prism has a first flat angled surface portion interfacing with and conforming to a flat angled surface portion of the first optical prism, the interfacing surface portions of the first and second optical prisms configured to split the electrosurgical or electromagnetic signal into at least the first and second signal portions.

[0013] In Example 4, the subject matter of Example 3 optionally includes the first optical prism that can include at least one reflective surface portion to reflect the second signal portion of the electrosurgical or electromagnetic signal to a power detector to measure a power of the electrosurgical or electromagnetic signal.

[0014] In Example 5, the subject matter of Example 4 optionally includes a parabolic reflector spatially aligned with the at least one reflective surface portion of the first optical prism, the parabolic reflector including a concave surface configured to reflect and converge the second signal portion to the power detector.

[0015] In Example 6, the subject matter of any one or more of Examples 3-5 optionally include the interfacing surface portions of the first and secondDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 optical prisms that can be further configured to reflect the at least a portion of the optical response signal to the feedback analyzer.

[0016] In Example 7, the subject matter of any one or more of Examples 3-6 optionally includes the plurality of pre-arranged optical prisms that can further include a third optical prism more proximally positioned to the optical path of the probe than the second optical prism, the third optical prism having a flat angled surface portion interfacing with and conforming to a second flat angled surface portion of the second optical prism, the interfacing surface portions of the second and third optical prisms configured to refract the at least a portion of the optical response signal to the interfacing surface portions of the first and second optical prisms.

[0017] In Example 8, the subject matter of any one or more of Examples 1-7 optionally includes an aiming source configured to generate an optical aiming signal for targeting the anatomical target and assisting in positioning the electrosurgical or electromagnetic signal at the anatomical target, wherein the integrated splitter assembly is further configured to pass therethrough the optical aiming signal to the optical path.

[0018] In Example 9, the subject matter of Example 8 optionally includes the aiming source to be configured to generate the optical aiming signal in a visible wavelength range.

[0019] In Example 10, the subject matter of any one or more of Examples 1-9 optionally include optics coupled between the optical splitter unit and the feedback analyzer, the optics configured to further redirect the at least a portion of the optical response signal, redirected by the integrated splitter assembly, to the feedback analyzer.

[0020] In Example 11, the subject matter of Example 10 optionally includes the optics that can include a mirror.

[0021] In Example 12, the subject matter of any one or more of Examples 10-11 optionally includes the optics that can include a parabolic reflector having a concave surface configured to reflect and converge the at least a portion of the optical response signal, redirected from the integrated splitter assembly, to the feedback analyzer.

[0022] In Example 13, the subject matter of any one or more of Examples 1-12 optionally includes a fiber optic coupler coupled to the opticalDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 path of the probe, the fiber optic coupler configured to split the optical response signal into sub-portions, and to direct at least one of the sub-portions to the feedback analyzer.

[0023] In Example 14, the subject matter of any one or more of Examples 1-13 optionally includes an optical circulator coupled to the optical path of the probe, the optical circulator configured to: transmit the at least a portion of the optical response signal to the feedback analyzer via a first pair of ports of the optical circulator; and transmit the electrosurgical or electromagnetic signal to the anatomical target via a second pair of ports of the optical circulator.

[0024] In Example 15, the subject matter of any one or more of Examples 1-14 optionally includes the energy source that can include a laser source to emit a treatment laser beam.

[0025] In Example 16, the subject matter of any one or more of Examples 1-15 optionally includes the feedback analyzer configured to identify a spectroscopic characteristic of the anatomical target based at least in part on the at least the portion of the optical response signal.

[0026] In Example 17, the subject matter of any one or more of Examples 1-16 optionally includes the anatomical target that can include a tissue target or a calculi target, and wherein the identified characteristic comprises at least one of a type, a material, a composition, a composition profile, a structure or hardness of the anatomical target.

[0027] In Example 18, the subject matter of any one or more of Examples 1-17 optionally includes a controller circuit configured to generate a control signal to adjust an output setting of the energy source based at least in part on the identified characteristic of the anatomical target.

[0028] Example 19 is an optical surgical system, comprising: a light source configured to generate illumination on an anatomical target; an energy source configured to generate an electrosurgical or electromagnetic signal to irradiate the anatomical target; a probe including an optical path configured to pass (i) the electrosurgical or electromagnetic signal to the anatomical target, and (ii) an optical response signal from the anatomical target in response to illumination thereof; and an optical splitter unit coupled between the energy source and the probe, the optical splitter unit including an integrated splitter assembly comprising first, second, and third optical prisms pre-arranged andDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 spatially registered to one another such that any one of the optical prisms has a flat angled surface portion interfacing with and conforming to a flat angled surface portion of another of the optical prisms, wherein: the second optical prism has a first flat angled surface portion interfacing with and conforming to a flat angled surface portion of the first optical prism, the interfacing surface portions of the first and second optical prisms configured to (i) split the electrosurgical or electromagnetic signal into at least the first and second signal portions, and (ii) reflect the at least a portion of the optical response signal to a feedback analyzer, the first optical prism includes at least one reflective surface portion to reflect the second signal portion of the electrosurgical or electromagnetic signal to a power detector to measure a power of the electrosurgical or electromagnetic signal; and the third optical prism having a flat angled surface portion interfacing with and conforming to a second flat angled surface portion of the second optical prism, the interfacing surface portions of the second and third optical prisms configured to refract the at least a portion of the optical response signal to the interfacing surface portions of the first and second optical prisms.

[0029] Example 20 is a method of operating an optical surgical system comprising an optical splitter unit and a probe coupled thereto to irradiate an anatomical target. The method comprises steps of: illuminating the anatomical target using a light source; splitting an electrosurgical or electromagnetic signal, generated by an energy source, into first and second signal portions using an integrated splitter assembly of the optical splitter unit, the integrated splitter assembly comprising a plurality of pre-arranged optical components spatially registered to one another; passing the first signal portion of the electrosurgical or electromagnetic signal through the integrated splitter assembly and an optical path of the probe onto the anatomical target; collecting, via the probe, at least a portion of an optical response signal from the anatomical target in response to illumination thereof; refracting and / or reflecting the collected at least a portion of the optical response signal via the integrated splitter assembly toward a feedback analyzer; and identifying a characteristic of the anatomical target based at least in part on the collected at least a portion of the optical response signal using the feedback analyzer.Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02

[0030] In Example 21, the subject matter of Example 20 optionally includes the integrated splitter assembly that can include first and second optical prisms pre-arranged and spatially registered to each other such that the second optical prism has a first flat angled surface portion interfacing with and conforming to a flat angled surface portion of the first optical prism, wherein splitting the electrosurgical or electromagnetic signal into at least the first and second signal portions is via the interfacing surface portions of the first and second optical prisms.

[0031] In Example 22, the subject matter of Example 21 optionally includes redirecting the second portion of the electrosurgical or electromagnetic signal to a power detector via at least one reflective surface portion of the first optical prism; and measuring a power of the electrosurgical or electromagnetic signal based at least in part on the redirected second signal portion.

[0032] In Example 23, the subject matter of Example 22 optionally includes positioning a parabolic reflector such that a concave surface thereof faces the at least one reflective surface portion of the first optical prism; and reflecting and converging the second signal portion of the electrosurgical or electromagnetic signal to the power detector.

[0033] In Example 24, the subject matter of any one or more of Examples 21-23 optionally includes refracting and / or reflecting the collected at least a portion of the optical response signal to the feedback analyzer, including reflecting the at least a portion of the optical response signal to the feedback analyzer via the interfacing surface portions of respective first and second optical prisms.

[0034] In Example 25, the subject matter of any one or more of Examples 21-24 optionally includes the integrated splitter assembly that can further include a third optical prism, the third optical prism having a flat angled surface portion interfacing with and conforming to a second flat angled surface portion of the second optical prism, wherein refracting and / or reflecting the collected at least a portion of the optical response signal to the feedback analyzer includes: refracting the at least a portion of the optical response signal via the interfacing surface portions of respective second and third optical prisms; and directing the refracted at least a portion of the optical response signal to the interfacing surface portions of the first and second optical prisms.Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02

[0035] In Example 26, the subject matter of any one or more of Examples 20-25 optionally includes passing an optical aiming signal, generated by an aiming source, through the integrated splitter assembly of the optical splitter unit; and directing the optical aiming signal through the optical path of the probe and onto an anatomical target to assist in positioning the electrosurgical or electromagnetic signal at the anatomical target.

[0036] In Example 27, the subject matter of any one or more of Examples 20-26 optionally includes refracting and / or reflecting the collected at least a portion of the optical response signal, including reflecting and converging the collected at least a portion of the optical response signal using a parabolic reflector.

[0037] In Example 28, the subject matter of any one or more of Examples 20-27 optionally includes coupling a fiber optic coupler to the optical path of the probe; feeding the collected at least a portion of the optical response signal to the fiber optic coupler to split it into sub-portions of signal; and directing at least one of the signal sub-portions to the feedback analyzer.

[0038] In Example 29, the subject matter of any one or more of Examples 20-28 optionally includes coupling an optical circulator to the optical path of the probe; transmitting the at least a portion of the optical response signal to the feedback analyzer via a first pair of ports of the optical circulator; and transmitting the electrosurgical or electromagnetic signal to the anatomical target via a second pair of ports of the optical circulator.

[0039] The presented techniques are described in terms of heal th -related procedures, but are not so limited. This summary is an overview of some of the teachings of the present application and not intended to be an exclusive or exhaustive treatment of the present subject matter. Further details about the present subject matter are found in the detailed description and appended claims. Other aspects of the disclosure will be apparent to persons skilled in the art upon reading and understanding the following detailed description and viewing the drawings that form a part thereof, each of which are not to be taken in a limiting sense. The scope of the present disclosure is defined by the appended claims and their legal equivalents.BRIEF DESCRIPTION OF THE DRAWINGDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02

[0040] FIG. 1 illustrates generally an example of an optical surgical system for identifying an anatomical target and providing feedback-controlled treatment.

[0041] FIGS. 2A-2E illustrate generally examples of an optical surgical system that includes a compact beam splitter assembly comprising a single multi-purpose splitter, and alternative design of optics for redirecting an aiming beam and an optical response signal from the target.

[0042] FIGS. 3A-3B illustrate generally examples of an optical surgical system that includes a compact beam splitter assembly comprising an integrated splitter assembly, such as pre-arranged prisms spatially registered to one another.

[0043] FIG. 4 illustrates generally an example of an optical surgical system that includes a compact beam splitter assembly comprising an optical circulator or coupler to split the optical response signal, and to more efficiently transmit various optical signals between an optical fiber and various signal sources or modules.

[0044] FIGS. 5A-5B illustrates generally examples of optical circulator or coupler that may be used in the system of FIG. 4.

[0045] FIG. 6 illustrates generally an example of an optical surgical system comprising an optical splitter unit and one or more parabolic reflectors to reflect and converge irradiating optical signals.

[0046] FIG. 7 illustrates an exemplary computer-based clinical decision support system (CDSS) that is configured to determine a proper laser output setting based on the sensor data.

[0047] FIGS. 8-9 are flowcharts illustrating example methods for operating an optical surgical system to identify one or more characteristics of a target and optionally, based thereon, providing treatment of the target.

[0048] FIG. 10 illustrates generally a block diagram of an example machine upon which any one or more of the techniques (e.g., methodologies) discussed herein may perform.DETAILED DESCRIPTION

[0049] This document describes systems, devices, and methods for collecting and transmitting an optical response signal from an anatomical target in response to illumination thereof, and using the optical response signal forDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 target identification and control of electrosurgical or electromagnetic treatment, such as laser treatment, of the target. According to one embodiment, an optical surgical system comprises an energy source to emit the electrosurgical or electromagnetic signal, an aiming source to generate an optical aiming signal for targeting the assisting in positioning the electrosurgical or electromagnetic signal at a desired location on the anatomical target, a probe defining an optical path to pass the electrosurgical or electromagnetic signal and the optical aiming signal the anatomical target and to pass an optical response signal from the anatomical target, and optical splitter unit to split the electrosurgical or electromagnetic signal into at least first and second signal portions. The optical splitter unit can reliably channel the electrosurgical or electromagnetic signal with minimal attenuation, while at the same time directing the optical response signal to a feedback analyzer (such as a spectroscopy system) with minimal distortion. The feedback analyzer can continuously or recurrently identify one or more characteristics (e.g., a type, a material, a composition, a composition profile, a structure or hardness) of the target in vivo throughout the procedure. Feedback may be provided to the energy source to adjust an output setting thereof within a specified range, automatically or with certain levels of user intervention, based on the identified target characteristics.

[0050] In this document, the terms “electrosurgical” and “electromagnetic” are used interchangeably, and the anatomical target can include, for example, anatomical tissue (e.g., soft tissue, hard tissue, or abnormal such as cancerous tissue) or a calculi target (e.g., kidney or pancreobiliary or gallbladder stone). The systems and devices discussed herein may be used endoscopically or laproscopically.

[0051] Conventional beam splitters generally comprise at least two separate reflectors, including a first reflector for reflecting an aiming beam out to the target via a laser fiber, and a second reflector for reflecting an optical response signal from the target into a feedback analyzer to identify a target characteristic. The first reflector may also serve as a splitter to split a treatment signal (e.g., a laser beam) into a first signal portion that passes through the reflector body and the laser fiber before irradiating the target, and a second signal portion that is reflected to a power monitor to measure laser output power. The multi -reflector design increases the system complexity, and generallyDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 requires precise alignment between the reflectors, which takes extra time and effort and can be costly and sometimes error-prone. The present disclosure describes an improved compact splitter design with a single multi-purpose splitter that can split the treatment signal (e.g., a laser beam) into first and second signal portions, pass through the splitter body the first signal portion and reflect the second signal portion to a power detector via one splitter surface, and reflect at least a portion of the optical return signal to the feedback analyzer via another splitter surface opposite the surface reflecting the second treatment signal portion. The single multi-purpose splitter can also reflect the optical aiming signal to the target via the splitter surface for reflecting the optical return signal. Compared to conventional multi -reflector splitters, the single multipurpose splitter as described in accordance with various embodiments in this document combines the aiming beam reflector and the optical response signal reflector into one common reflector / splitter within a fiber cable, thus achieving multiple signal reflection requirements, along with directing the treatment signal to the target, in a single package with fewer components and simpler design. The reduced system complexity improves robustness of optical and mechanical construction and overall system reliability, and reduces the manufacturing and operation cost. The reduced system complexity also helps reduce optical loss and lessen the interfering effect of aiming beam emission on the target spectra, thereby improving the quality of the optical response signal and the accuracy of target characteristics identification.

[0052] According to another embodiment, the compact splitter unit can include an integrated splitter assembly comprising a plurality of pre-arranged optical components spatially registered to one another, such as a pre-arranged assembly of prisms each having a flat angled surface portion interfacing with and conforming to a flat angled surface portion of another prism. The integrated splitter assembly can split a treatment signal (e.g., a laser beam) into at least first and second signal portions, pass through the integrated splitter assembly the first signal portion and reflect the second signal portion to a power detector, reflect at least a portion of the optical return signal to the feedback analyzer, and redirect an optical aiming signal to the target. Reflection and / or refraction of various optical signals can happen at interfacing surface portions of two spatially registered prisms. Compared to conventional multi -reflector splitter whichDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 requires at least two separate reflectors be serially positioned and properly aligned, the optical components (e.g., prisms) of the integrated splitter assembly as described in this document are registered to one another in accordance with a predefined arrangement, thereby obviating the need for component alignment and avoiding potential alignment errors. Accordingly, more robust optical and mechanical construction, improved system reliability, and reduced development and operation cost can be achieved.

[0053] Various embodiments of the compact splitter unit as described in this document involve one or more parabolic reflectors to reflect and converge optical signals incident thereon. Compared to reflectors of other shapes (e.g., a flat reflector), the parabolic reflector can more efficiently collect and converge a large amount of optical signals without additional components. The reduced complexity (with fewer optical components) simplifies yet improves robustness of optical and mechanical construction, improves the system reliability and reduces the development and operation cost. The reduced complexity also helps simplify alignment procedure, reduces alignment error, reduce optical loss and thus improves response signal quality and usability. Accordingly, overall system reliability can be improved.

[0054] Identifying the character! stic(s) (e.g., a type, a material, a composition, a composition profile, a structure or hardness) of tissue in vivo via an endoscope or laparoscope has numerous applications. For example, if the composition of a renal calculus is determined a priori, the treatment method may be based at least in part on the composition of the stone. For example, when using a laser to break-up or “dust” a stone, if it were known a priori that the stone had a hard composition, then the laser settings may be adjusted to settings that perform more effectively and / or efficiently on a hard kidney stone.

[0055] Also, techniques that require removal of a tissue sample to identify the composition cannot monitor the composition of the tissue on an ongoing basis through all or at least a portion of entire procedure. The present techniques can allow measurement and analysis of the characteristic(s) (e.g., a type, a material, a composition, a composition profile, a structure or hardness) of an anatomical target or a calculi target at the tip of the endoscope or laparoscope. These techniques can provide more information during a health related procedure, such as a surgical or diagnostic procedure, to better adapt a treatmentDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 method during the procedure. For example, if a procedure involves breaking a renal calculus into tiny pieces, e.g., “dusting” the renal calculi, and the renal calculus has a hard surface, but a soft core, the continuous or other ongoing monitoring of target composition via the endoscope or laparoscope can allow adjustment of, for example, a setting of the instrument doing the “dusting” during the procedure, such as laser settings for a laser ablation instrument. The identification of the target can allow for first providing settings that perform better (e.g., more effectively and / or efficiently) on the hard surface of the stone to then providing settings that perform better on the soft core of the stone.

[0056] FIG. 1 illustrates generally an example of an optical surgical system 110 that can identify characteristics a target 117 in a patient’s body, and treats the target 117 with electrosurgical or electromagnetic energy (e.g., laser). Examples of the target 117 can include anatomical tissue (e.g., soft tissue, hard tissue, or abnormal such as cancerous tissue) or a calculi target (e.g., kidney or pancreobiliary or gallbladder stone). The optical surgical system 110 can include visualization equipment such as an endoscope 101, a target identification system 100, primary medical instrument such as an energy system 102 (such as a surgical laser system), a power detector 150, and an aiming source 160. The endoscope 101 can include an endoscope probe 103, a light source 104, and a display 105. The endoscope probe 103 can include a camera 106, one or more optical signal communication pathways 107, 108, and at least one working lumen 111. A distal portion of the endoscope probe 103 can be inserted within a patient’s body. The light source 104, one or more optical paths 107, 108, and display 105 can allow an end-user, such as a physician or surgeon or robotic device, to illuminate and observe an internal area of the patient’s body at or near the distal end 109 of the endoscope probe 103. The light source 104 can emit electromagnetic radiation (e.g., visible light, infrared light, ultraviolet light, or fluorescent light) to illuminate the area at or beyond the distal end 109 of the endoscope probe 103 via a first optical path 108. Alternatively, the light source 104 may include an illumination light, such as one or more LEDs of a visualization system, positioned at a distal end of an endoscope and configured to illuminate the area proximate to the target 117. In an example, the second optical path 107 can communicate image signal information from the camera 106 at the distal end 109 of the endoscope probe 103 to signal processingDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 circuitry at the display 105 for displaying an image of the area at or beyond the distal end 109 of the endoscope probe 103, such as an image of the target 117. In some examples, the second optical path 107 can include one or more components such as one or more optical fibers, and the display 105 can include an eyepiece for the end-user to observe the area at or beyond the distal end 109 of the endoscope probe 103. In certain examples, the second optical path 107 can couple viewing image signal information from the camera 106 to the display 105 such as for the end-user to observe the area at or beyond the distal end 109 of the endoscope probe 103. In some examples, the camera 106 can be located at or near the proximal end of the endoscope probe 103, such as near the display 105, and one or more optical fibers can form the second optical path 107 to transmit the image information from the distal end 109 of the endoscope probe 103 to the camera 106. In some examples, the camera 106 can be located at the distal end 109 of the endoscope probe 103, and image information can be transmitted to the display 105 via electrical conductors forming at least a portion of the second optical path 107 integrated with the endoscope probe 103.

[0057] The working lumen 111 can further allow the end-user to insert and extract a portion of the primary medical instrument (such as one or more surgical tools) for operating about the targeted internal region of the patient’s body being visualized using the endoscope probe 103. For example, for the energy system 102, the primary medical instrument can include a working probe 113 and an energy source, such as laser source 112, to allow ablation of target tissue or a calculi structure at or near the distal end 109 of the endoscope probe 103. In such a system, for either endoscopic or laparoscopic procedures, an electrosurgical or electromagnetic signal (also referred to as a treatment signal) produced by the energy source, such as a laser beam 118 produced by the laser source 112, can pass through the working lumen 111 and irradiate the target 117. In certain examples, the laser beam 118 can have a wide wavelength range from ultraviolet (UV) to infrared (IR) (e.g., 200 nm to 10000 nm). Some lasers can produce an output in a wavelength range that can be highly absorbed by soft or hard tissue, for example 1900-3000 nm for water absorption or 400-520 nm for oxy-hemoglobin and / or deoxy-hemoglobin absorption.

[0058] The target identification system 100 can include an optical splitter unit 114, and a spectroscopy system 115. In some examples, the working probeDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02113 may be a part of the target identification system 100. As will be discussed further below with respect to FIGS. 2A-2E and 3 A-3B, the optical splitter unit114 may include a single multi-purpose splitter (as shown in FIGS. 2A-2E) or an integrated splitter assembly (as shown in FIGS. 3A-3B), each of which can split the electrosurgical or electromagnetic signal, such as the laser beam 118, into first and second signal portions, and redirect various optical signals to respective optical components.

[0059] The optical splitter unit 114 can be optically coupled to one or more of the endoscope probe 103, the laser source 112, the aiming source 160, the spectroscopy system 115, and the power detector 150 via one or more ports. As illustrated, the optical splitter unit 114 can include: (i) a first port 121 to receive a common optical path 130 within the working probe 113 for passing a first signal portion 118A split from the laser beam 118 by the optical splitter unit 114, and a back-scattered or wavelength-shifted optical response signal 119 reflected or radiated from the target 117 in response to illumination thereof; (ii) a second port 122 to receive an optical path coupled to the laser source 112; (iii) a third port 123 to receive a feedback signal optical path for directing the optical response signal to the spectroscopy system 115, and another optical path for receiving an aiming signal 162 from the aiming source 160; and (iv) a fourth port 124 for receiving an optical path for passing a second beam portion 118B split from the laser beam 118 by the optical splitter unit 114 to power detector 150.

[0060] The power detector 150 can measure the power of the second signal portion 118B, or estimate total power of the laser beam 118 or the first signal portion 118A incident on the target 117 based on the power measurement of the second signal portion 118B. In some examples, the single multi-purpose splitter, or the integrated splitter assembly, of the optical splitter unit 114 can have a reflective coating to reflect certain wavelength(s) of the laser beam 118 to the power detector 150.

[0061] The aiming source 160 can generate an aiming signal 162 for targeting the target 117, and assisting in positioning the laser beam 118 on the target 117. In an example, the aiming source 160 includes a laser diode that can generate a laser beam in a visible wavelength range. The aiming signal 162 can have a relatively lower power than the electrosurgical or electromagnetic signalDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02(e.g., the laser beam 118) irradiating the target 117. In an example, the aiming signal 162 can be activated for targeting before the laser source 112 is turned on to emit the laser beam 118.

[0062] The spectroscopy system 115 can include a spectrometer 128 and an analyzer circuit 116. In an example, the target identification system 100 can use information of the optical response signal 119 to assist in determining one or more characteristics (e.g., a material or a composition) of the target 117. The optical response signal 119 can include, for example, light visible to the human eye, florescent emissions, ultra-violet light, infrared light, or combinations thereof.

[0063] In certain examples, information of the optical response signal 119 can be used to more efficiently execute a procedure. In an example, electromagnetic radiation from the light source 104 incident on the target can be reflected off of the target 117 within the internal area of the patient’s body at or near the distal end 109 of the endoscope probe 103, or can cause the target 117 to emit optical information, such as by florescence, for example. Optical information conveyed via the optical response signal 119 is also referred to as image response information or optical response information herein. The spectrometer 128 can be optically coupled to the optical splitter unit 114, and provide spectral measurements from the optical response signal 119. Examples of the spectrometer 128 may include a Fourier Transform Infrared (FTIR) spectrometer, a Raman spectrometer, a UV-VIS spectrometer, a UV-VIS-IR spectrometer, or a fluorescent spectrometer, among others.

[0064] Spectroscopy / spectrometry techniques can be used to identify the characteristic(s) (e.g., a type, a material, a composition, a composition profile, a structure or hardness) via the spectrum reflected, transmitted, emitted, absorbed, or not absorbed by a target surface. Optical spectroscopy can provide timely analysis of organic and inorganic materials. For ablation, optical spectroscopy can help provide several advantages, such as including, but not limited to, integration with fiber laser ablation techniques, nondestructive methods of material chemical composition analyses, real-time or near real-time composition estimates or composition profiles, and applicability for analyses of different types of biological materials: hard and soft tissue, stones, and others.Spectroscopic techniques can be used alone or in combination to analyze hard orDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 soft tissue chemical composition, and generate digital spectral data. Examples of the digital spectral data may include one or more characteristic spectral features extracted from a reference spectrum. Examples of the characteristic reflectance features may include reflectance intensity (or normalized reflectance spectral intensity) at a specific wavelength or over a wavelength range, a statistical value calculated from the reflectance spectrum (e.g., a variation of reflectance over two or more different wavelengths, a rate of change of reflectance over a range of wavelengths, or the like), or a graphical feature representing the morphology of at least a portion of the spectral reflectance curve (e.g., a slope, a curvature, a segment of the curve, or the like). In some examples, one or more types of spectroscopy, including but not limited to, color, ultra-violet, deep ultra-violet, visual light, near-infrared, and florescent spectroscopy, can be used with the endoscope 101 to identify the composition of the target 117. In an example, the spectroscopy system 115 can (i) initiate and control the light source 104 to illuminate the target 117 via, for example, the first optical path 108 of the endoscope probe 103, (ii) receive optical response signal 119 reflected or radiated from the target 117 such as via an optical path of the working probe 113 (such as the common optical path 130), and (iii) generate spectral data based on the optical response signal 119.

[0065] The analyzer circuit 116 can determine, from the spectral measurement generated by the spectrometer 128, characteristic(s) of the target 117, such as a type, a material, a composition, a composition profile, a structure or hardness, based on the spectral measurements. In an example, the analyzer circuit 116 can determine a composition profile of the materials represented by the spectral data, and display the composition profile. The composition or structure information can be useful to help provide feedback that can be used for more efficiently performing the surgical procedure. For example, the analyzer circuit 116 can compare the spectroscopic response signal with an available database library of tissue composition data. The analyzer circuit 116 can identify target material composition based on the spectroscopic response signal and suggest a configuration for the energy system 102 to achieve effective tissue treatment for the identified tissue composition. In an example, the analyzer circuit 116 can identify a calculi target as one of a plurality of calculi types with distinct compositions, such as tones or stone fragments in various stone-formingDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 regions such as urinary system, gallbladder, nasal passages, gastrointestinal tract, stomach, or tonsils. In an example, the calculi target may be identified as one of stone types with distinct chemical compositions, such as one of a calcium phosphate (CaP) stone, a magnesium ammonium phosphate (MAP) stone, a monohydrate calcium oxalate (COM) stone, a cholesterol-based stone; a dihydrate calcium oxalate (COD) stone, a cystine stone, or a uric acid (UA) stone. In another example, the analyzer circuit 116 can identify an anatomical tissue target as one of a plurality of tissue types, such as soft tissue (e.g., muscles, tendons, ligaments, blood vessels, fascia, skin, fat, and fibrous tissues), hard tissue such as bone, connective tissue such as cartilage, among others. In some example, the anatomical tissue target may be identified as one of tissue types with distinct anatomical locations. For example, a renal tissue target may be identified as one of calyx tissue, cortex tissue, medulla tissue, or ureter tissue. In another example, an identified tissue target may be identified as normal tissue or abnormal tissue (e.g., cancerous tissue). In yet another example, an identified tissue target may be identified as treatment area (e.g., tumor or polyp intended for removal) or a non-treatment area (e.g., blood vessels, muscle, etc.).

[0066] In certain examples, the analyzer circuit 116 can provide one or more control signals or control data to adjust a setting of the energy system 102. In a laser ablation example, the analyzer circuit 116 or an intermediate device, can include control circuitry to program or adjust laser settings automatically based on the target characteristic(s) (e.g., a type, a material, a composition, a composition profile, a structure or hardness). Examples of adjusting the laser settings may include delivering or withhold delivering the laser beam, or adjust a laser beam parameter such as wavelength, power, power density, energy, or a pulse parameter (e.g., pulse width, pulse rate, amplitude, duty cycle, pulse shape), exposure time, total dose or energy, or one or more combinations thereof, among others. In some examples, adjustment of the laser settings can be limited or constrained to be within a set individual or multivariate safe operating range such as based on a setting selected by the end-user at the start of the procedure.

[0067] In various examples, operation of the system, such as the laser output setting, can be determined or adjusted using artificial intelligence (Al) or machine learning (ML) based techniques. For example, information about theDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 identified type or composition of the anatomical target may be applied to a trained ML model to automatically determine a proper laser setting to be used during the procedure. Examples of using a trained ML model to determine a laser output setting are discussed below with respect to FIG. 7.

[0068] In certain examples, the spectroscopy system 115 can optionally communicate with a database 129. In some examples, the database 129 can be a repository for storing measurements and other information associated with a procedure. In some examples, as the database collects more information, the spectroscopy system 115 or a portion thereof, such as the analyzer circuit 116, can interact with information of the database 129 to determine, for example, the most efficient application of the laser system 102 based on spectroscopic information collected or analyzed during the procedure and / or compared with the historical information available in the database 129. In certain examples, the database may be able to provide temporal recipe (e.g., such as laser pulse parameter values and / or temporal variations thereof) for configuring the energy system 102 as the spectroscopic information of a procedure is collected and analyzed. In certain examples, the database 129 can include an internet-based or a cloud-based database and may include applications designed for interacting with a analyzer circuit 116 or some other portion of the spectroscopy system 115 to assist in executing an efficient surgical procedure based on historical procedure information and / or adaptive to the specific spectroscopic information collected during the procedure.

[0069] For example, for a laser ablation system, the laser settings that can be part of a recipe for configuration of the energy system 102 can include, but are not limited to, laser operation mode (e.g., pulse or continuous wave), power, energy, frequency, pulse shape, pulse profile, or one or more combinations thereof. In certain examples, the energy system 102 can operate in an automatic mode or a semi-automatic mode among other modes. In the automatic mode, the laser settings can be automatically controlled based on the identified target character! stic(s) (e.g., a type, a material, a composition, a composition profile, a structure or hardness). In the semi-automatic mode, the laser settings can be adjusted based on the identified target characteristic(s) after receiving some confirmatory indication of an operator’s approval for making the setting change. The combination of the energy system 102, spectroscopy systemDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02115, and the analyzer circuit 116 can be used in an ongoing intraoperative feedback mode such as to continuously or recurrently identify the characteristic(s) (e.g., a type, a material, a composition, a composition profile, a structure or hardness) of target 117 through the working probe 113 and update the laser settings during or throughout a procedure. It is understood that other surgical techniques besides laser-based surgical techniques as discussed herein are possible to use with the target identification system 100 without departing from the scope of the present subject matter

[0070] In certain examples, a single optical path of the working probe 113 of the target identification system 100 can be used to transport a first optical signal (such as the laser beam 118) to or from the target 117 at the distal end 109 of the working probe 113 and can also be used to transport a second optical signal (such as the optical response signal 119) from the distal end 109 of the working probe 113 to the spectroscopy system 115. The optical splitter unit 114 can merge multiple optical paths into a single optical path or to separate optical information from a common optical path (such as the optical path 130) to one or more separate optical paths.

[0071] Various compact designs of the optical splitter unit 114 have been contemplated by the present inventors to reduce the number of optical components in the splitter unit and improve the robustness and efficiency of splitting and / or channeling various optical signals entering the splitter unit. FIGS. 2A-2B are block diagrams illustrating, by way of example and not limitation, respective optical surgical systems 200A and 220B each including a compact optical splitter unit 214, which can be an embodiment of the optical splitter unit 114 of FIG. 1. The compact optical splitter unit 214 can include a number of signal input / output ports 221-224, corresponding to the ports 121-124 of the optical splitter unit 114. Specifically, a first port 221 can receive the common optical path 130, such as a surgical fiber in an endoscope, for passing the first beam portion 118A, split from the laser beam 118, to the target 117, as well as for passing the optical response signal 119 from the target 117. A second port 222 can receive a second optical path, such as a laser fiber 230, coupled to the laser source 112 for passing the laser beam 118 generated from the laser source 112 to the compact optical splitter unit 214. A third port 223 is a common port that can receive a third optical path, such as a spectrometer fiber 240 forDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 passing the optical response signal 119 to the spectroscopy system 115, and an aiming beam fiber for passing the aiming beam 162, preferably filtered by an aiming beam filter 161 to certain wavelength(s), into the compact optical splitter unit 214. The fourth port 224 can receive a fourth optical path, such as a laser fiber for passing the second beam portion 118B to the power detector 150.

[0072] The compact optical splitter unit 214 can include a single multipurpose splitter 270, and an optional lens system comprising a collimating lens 242 and a focusing lens 244 for collimating and focusing the laser beam 118 or a portion thereof, respectively. By way of non-limiting example and as illustrated, the collimating lens 242 and the focusing lens 244 can be positioned on opposite sides of the single multi-purpose splitter 270 along the optical path extending between the ports 222 and 221. The single multi-purpose splitter 270 can have first and second opposite surfaces 271 and 272 to reflect various incoming optical signals. The single multi-purpose splitter 270 can be positioned and oriented relative to the laser source 112, the aiming source 160, and the power detector 150, such that: (i) the aiming beam 162, and a portion of the optical response signal 119, are reflected by the first surface 271; and (ii) the laser beam 118 irradiating the second surface 272 is split into a first beam portion 118A that passes through the splitter body and the optical path 130 and ultimately reach the target 117, and a second portion 118B that is reflected by the second surface 272. The redirected second beam portion 118B, upon exiting the fourth port 224, can be attenuated by a neutral density (ND) filter 251 and subsequently converged by a focusing lens 252, before reaching the power detector 150 where a power measurement and / or estimation can be performed.

[0073] Compared to conventional splitter systems which generally requires separate, serially positions and spatially aligned reflectors including a first reflector to direct the aiming beam and a second reflector to redirect the optical response signal, the single multi-purpose splitter 270 simplifies the splitter unit of the optical surgical system. As the aiming beam 162 and the optical response signal 119 are both reflected by the same first surface 271 of the single multi-purpose splitter 270, the optical surgical system comprises common optics to facilitate passage of the aiming beam 162 and the optical response signal 119 to respective optical components. In the example as shown in FIG. 2A, the common optics 260A comprise a hollow lens 262 and a hollow reflectorDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02264. The hollow lens 262, such as a hollow focusing lens as shown, has an aperture (e.g., a through-hole) extending between two opposite lens surfaces. The hollow reflector 264 similarly has an aperture (e.g., a through -hole) extending between two opposite surfaces thereof. The apertures may be located at substantially the surface center of respective devices. Alternatively, the apertures may be located at other locations of the respective devices. The apertures of the hollow lens 262 and the hollow reflector 264 can be sized, shaped, and positioned to be spatially aligned with each other to allow the aiming beam 162 to pass therethrough with little or no attenuation or distortion before entering compact optical splitter unit 214 through the third port 223. The aiming beam 162 can then be reflected by the first surface 271 of the single multi-purpose splitter 270, and enter the common optical path 130.

[0074] The portion of the optical response signal 119, reflected by the first surface 271 of the single multi-purpose splitter 270, can exit the compact optical splitter unit 214 via the third port 223, and get redirected by the common optics 260A (the hollow lens 262 and the hollow reflector 264). The hollow reflector 264 can have a reflective surface portion facing the hollow lens 262, which can reflect the incoming optical response signal 119. The reflected optical response signal can be filtered using a notch filter 281, pass through the optical fiber 240 coupled between a subminiature assembly (SMA) fiber optic connector 282 and the spectroscopy system 115.

[0075] FIG. 2B illustrates an optical surgical system 200B, which is similar to the surgical system 200 A of FIG. 2 A except for an alternative design of the common optics 260B for channeling the aiming beam 162 and the optical response signal 119 to respective optical components. The common optics 260B comprise a partially reflective optical element 266, such as a flat partially reflective mirror with two opposite flat surfaces. The partially reflective optical element 266 can have a reflective surface portion 266A on a flat surface facing the third port 223, and an anti-reflective coated surface portion 266B on a flat surface facing the aiming source 160 (and optically further on the flat surface facing the third port 223). The reflective surface portion 266A can reflect the incoming optical response signal 119, which is then directed to the notch filter 281, the SMA fiber optic connector 282, and the optical fiber 240 leading to the spectroscopy system 115. The anti -reflective coated surface portion 266B can beDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 sized and shaped to allow the aiming beam 162 to pass through the body of the optical element 266 therefrom with little or no distortion or attenuation, before entering the compact optical splitter unit 214 through the third port 223.

[0076] In contrast to the mechanical aperture (e.g., a through -hole) on the hollow reflector 264 of FIG. 2 A, the anti -reflective coated surface portion 266B functions as an “optical hole” on the partially reflective optical element 266. The anti -reflective coating on the surface portion 266B can be made of wavelength sensitive material or dichroic material or a combination thereof. Suitable anti-reflective coating material can include SiO2 (refractive index between about 1.4 and about 1.5), SiO (refractive index between about 1.8 and about 1.9), Si3N4 (refractive index of about 1.9), TiO2 (refractive index of about 2.3), Ta2O5 (refractive index between about 2.1 and about 2.3), MgF2 (refractive index between about 1.4 and about 1.5), BaF2 (refractive index of about 1.47), CaF2 (refractive index of about 1.39), among others. The anti- reflective coating can be transparent or anti -reflective to the wavelength of the aiming beam 162, but highly reflective to wavelengths of interest of the optical response signal 119. FIG. 2C illustrates reflectance spectra 263 of the anti- reflective coating on the surface portion 266B, with a spectral notch 265 at wavelength(s) of the aiming beam, which is in this example approximately 520- 530 nm range. The substantially lower reflectance at this wavelength range may increase throughput of the aiming beam 162 through the body of the partially reflective optical element 266.

[0077] In some examples, the common optics 260B may additionally include an optical lens aligned with the partially reflective optical element 266. Such optical lens, along with the reflective surface portion 266A of the partially reflective optical element 266, can reduce optical loss from the optical response signal 119 to be used for target analysis and identification. A nonlimiting example of such optical lens, as illustrated in FIG. 2B, is the hollow lens 262 as descried above with respect to FIG. 2A. The anti -reflective coated surface portion 266B can be spatially aligned with the aperture of the hollow lens 262 to facilitate passage of the aiming beam 162. Other optical lens(es) may be used.

[0078] FIGS. 2D-2E illustrate respective optical surgical systems 200D and 200E, which are similar to the surgical systems 200 A and 200B of FIG. 2A- 2B, each including alternative designs of common optics 260D and 260E forDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 channeling the aiming beam 162 and the optical response signal 119 to respective optical components. The common optics 260D comprise a parabolic reflector 268A, and the common optics 260E comprise a parabolic reflector 268B. Such parabolic reflectors each can reflective and converge the portion of the optical response signal 119, then direct it to the optical fiber 240 leading to the spectroscopy system 115. The parabolic reflectors each have a concave surface such oriented to face the third port 223 to receive the incoming optical response signal 119 reflected from the single multi-purpose splitter 270. To facilitate transmission of the aiming beam 162 with little or no distortion or attenuation, the parabolic reflector can have a mechanical aperture (e.g., a through-hole) similar to that of the hollow reflector 264 in FIG. 2A, or an “optical aperture” (e.g., an anti-reflective coating) similar to that of the partially reflective optical element 266 in FIG. 2A. By way of example and not limitation, FIG. 2D illustrates a hollow parabolic reflector 268A with a through-hole sized and oriented to pass the aiming beam 162 unobstructedly therethrough, and FIG. 2E illustrates a partially reflective parabolic reflector 268B with anti-reflective coated surface portion 266B sized and positioned to pass the aiming beam 162 through the corresponding body portion of the parabolic reflector 268B before entering the compact optical splitter unit 214.

[0079] In some examples, a separate parabolic reflector may be used to further reflect and converge the second beam portion 118B reflected by the single multi-purpose splitter 270 before it gets into the power detector 150. As an alternative to the focusing lens 252 in FIGS. 2 A and 2B, FIGS. 2D-2E show a parabolic reflector 253 to reflect and converge the second beam portion 118B to the power detector 150. The parabolic reflectors 268A, 268B, and 253, can more efficiently collect and converge a large amount optical signals without additional optical components.

[0080] FIG. 3 A is a block diagram illustrating an example of an optical surgical system 300, which can be a variation of the optical surgical system 200A or 220B as described above. The optical surgical system 300 comprises a compact optical splitter unit 314, which can include an integrated splitter assembly 310, and a lens system comprising a collimating lens 242 and a focusing lens 244 as similarly described above with respect to FIGS. 2A-2B. The integrated splitter assembly 310 can be positioned between the collimating lensDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02242 and the focusing lens 244 along the optical path defined between the second port 222 and the first port 221. The integrated splitter assembly 310 can include a plurality of pre-arranged optical components spatially registered to one another. The integrated splitter assembly 310 can split the incoming laser beam 118 into a first beam portion 118A that passes through the body of integrated splitter assembly 310 and enters the optical path 130 and ultimately irradiates the target 117, and a second beam portion 118B redirected to the power detector 150. The integrated splitter assembly 310 may further redirect the aiming beam 162 to the optical path 130 and then to the target 117, and receive and redirect at least a portion of the optical response signal 119 to the spectroscopy system 115 via the spectrometer fiber 240.

[0081] An example of the integrated splitter assembly 310, as illustrated in FIG. 3B, is a prism assembly 310 comprises a plurality of optical prisms, such as prisms 311, 312, and 313 as shown, that are spatially registered to one another and serially arranged. According to one example of the pre-arrangement, the prism 311 is positioned proximal to the second port 222, the prism 313 positioned proximal to the first port 221, and the prism 212 is registered between the prism 311 and 313. Each prism has a flat angled surface portion interfacing with and conforming to a flat angled surface portion of another prism. The interfacing flat surface portions of the prisms can reflect and / or refract at least a portion of an optical signal incident thereon. Optical signals enter or exit the integrated splitter assembly 310 via one of a plurality of access points 321, 322, 323, and 324 located at flat surfaces of two or more prisms. In the illustrated example, interfacing flat surface portions of prisms 311 and 312 function as a first optical filter 331, and interfacing flat surface portions of prisms 312 and 313 function as a second optical filter 332. In various examples, one or more surface portions of one or more prisms, including one or more interfacing flat surface portions of the filters 331 or 332, may be treated with reflect coating to enhance reflection of incoming optical signals, or with anti -reflective coating to reduce reflection and improve light throughput through the body of one or more prisms.

[0082] In the illustrated example, the laser beam 118, emitted from the laser source 112, can enter the integrated splitter assembly 310 via the second access point 322 located on a flat surface of the prism 311. The laser beam 118 can get split off at the interfacing surface portions of the first optical filter 331Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 into a first beam portion 118A and a second beam portion 118B. The first beam portion 118A can get refracted, pass through bodies of prisms 312 and 313, exit the first access point 321, enter the common optical path 130, and ultimately reach the target 117. The second beam portion 118B can be reflected by the interfacing surface portions of the first optical filter 331, further reflected by one or more surfaces of the prism 311, exit the fourth access point 324, and ultimately enter the power detector 150.

[0083] At least a portion of the optical response signal 119 from the target 117 can be collected by the optical fiber and travel back along the optical path 130 to the integrated splitter assembly 310 via the first access point 321 located on a flat surface of the prism 313. The optical response signal 119 can then pass through the body of prism 313, get refracted by the interfacing surface portions of the filter 332, pass through the body of prism 312, and get reflected by the interfacing surface portions of the filter 331, and exit the third access point 323, and ultimately enter the spectroscopy system 115 via the spectrometer fiber 240.

[0084] The aiming beam 162, emitted from the aiming source 160, can enter the integrated splitter assembly 310 via the second access point 322, the same access point where the laser beam 118 enters the integrated splitter assembly 310. The aiming beam 162 can pass through the body of first prism 311, get refracted by the first optical filter 331, pass through the body of the second prism 312, get refracted by the second optical filter 332, pass through the body of the third prism 313, exit from the first access point 321, then enter the common optical path 130. The aiming signal 162 can have a relatively lower power than the laser beam 118 for irradiating the anatomical target. In an example, the aiming signal 162 can be activated for targeting before the laser beam 118 is turned on.

[0085] In various examples, the optical surgical system 300 may include optics defining an optical path between the optical splitter unit 114 and the spectroscopy system 115. Such optics can further redirect the optical response signal 119, redirected from the optical splitter unit 114, to the spectroscopy system 115. The optics can include a mirror in one example, or in another example, a parabolic reflector having a concave surface to reflect and converge the optical response signal 119, redirected from the integrated splitter assembly,Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 to the spectroscopy system 115, such as the parabolic reflector 268 A or 268B of FIGS. 2D and 2E. In some examples, a different parabolic reflector, such as the parabolic reflector 253 of FIGS. 2D and 2E, can be spatially aligned with the access point 324 located on a surface portion of the prism 311, to converge and reflect the second beam portion 118B to the power detector 150.

[0086] FIG. 4 illustrates is a block diagram illustrating an example of an optical surgical system 400 that includes a compact optical splitter unit 414. Similar to the compact optical splitter unit 214 as shown in FIGS. 2A-2B and 2D-2E, the compact optical splitter unit 414 can include single multi-purpose splitter 270. The compact optical splitter unit 414 can additionally include an optical circulator or coupler device 410, such as coupled between the single multi-purpose splitter 270 and the optical path 130 of the probe, and positioned proximal to the first optical port 221 of the compact optical splitter unit 414. The optical circulator or coupler device 410 can split the optical response signal 119, and / or to more efficiently transmit various optical signals coming into the circulator or coupler device 410. As will be described further below with respect to FIGS. 5A-5B, the optical circulator or coupler device 410 can transmit the optical response signal 119, or a portion thereof, to the spectroscopy system 115, while at the same time allowing the laser beam portion 118A split off by the single multi-purpose splitter 270, and the aiming beam 162, to be transmitted to the optical path 130 with little or no attenuation.

[0087] FIG. 5 A illustrates an optical circulator 510 having three ports 511, 512 and 513. The optical circulator 510 allows unidirectional transmission of optical signals, such that an optical signal entering any port can exist only from the immediate next port (in accordance with a predetermined circulating direction 515) with minimum loss. In an example, the optical circulator 510 can be such configured that the first port 511 receives the common optical path 130, the second port 512 receives the spectrometer fiber 240, and the third port 513 receives the optical path for directing the first beam portion 118A and the aiming beam 162. Accordingly, the optical response signal 119 entering the first port 511 can only exit from the second port 512 with minimum loss (i.e., substantially 100% transmission), then pass through the spectrometer fiber 240 and reach the spectroscopy system 115. The laser beam portion 118A and the aiming beam 162, entering the third port 513, can only exit from the first portDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02511 with minimum loss, and pass through the optical path 130 to irradiate the target 117.

[0088] FIG. 5B illustrates a fiber optic coupler 520 having three ports: a first port 521 on a distal portion of the coupler to receive the common optical path 130, and a second port 522 and a third port 523 on the same proximal portion (opposite the distal portion) of the coupler, where the second port 522 is to receive the spectrometer fiber 240, and the third port 523 is to receive a path directing the first beam portion 118A and the aiming beam 162. Also referred to as a 1x2 single mode (SM) fused fiber optic coupler or “tap,” the fiber optic coupler 520 can split an input optical signal entering a port at one end (e.g., distal or proximal) into different signal portions exiting respective different ports at the opposite end (e.g., proximal or distal). The power distribution ratio between the split signal portions can be precisely controlled, such as 10 / 90%, 20 / 80%, 30 / 70%, 40 / 60%, or 50 / 50%, among other distribution ratios.Accordingly, in the example shown in FIG. 5B, the optical response signal 119 entering the first port 521 can be split into (i) a first response signal portion 119A that exits the second port 522, and (ii) a second response signal portion 119B that exits the third port 523. The first response signal portion 119A can pass through the spectrometer fiber 240 and reach the spectroscopy system 115 where spectral analysis and target identification can be performed. The first beam portion 118A and the aiming beam 162 that enter the third port 523 can exit the first port 521. Because only one fiber is present on the distal end, no signal splitting would occur, and the first beam portion 118A and the aiming beam 162 can pass through the optical path 130 to irradiate the target 117.

[0089] FIG. 6 is a block diagram illustrating an optical surgical system 600, which is a variation of the optical surgical systems 200D and 200E shown in FIGS. 2D-2E. The optical surgical system 600 comprises an optical splitter unit 614 and one or more parabolic reflectors to reflect and converge irradiating optical signals. In contrast to the compact optical splitter unit 214 of the systems 200D and 200E, two separate reflectors 670 and 680 can be included and serially positioned along the optical pathway within the optical splitter unit 614. The reflector 670 can split the laser beam 118, via a surface 672 of the reflector 670, into the first beam portion 118A (which pass through the reflectors 670 and 680 and enters the common optical path 130) and the second beam portion 118BDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02(which gets redirected, such as via the parabolic reflector 653, to the power detector 150). The reflector 670 can further reflect, via an opposite surface 671, the aiming beam 162 (which enters the optical splitter unit 614 via a port 223B) into the common optical path 130. The reflector 680 is a dedicated reflector for reflecting the optical response signal 119, which then gets redirected, such as via the parabolic reflector 668, to the spectroscopy system 115.

[0090] As illustrated, the optical splitter unit 614 can include a first parabolic reflector 668, and / or a second parabolic reflector 653. The first parabolic reflector 668 has a concave surface to reflect and converge the optical response signal 119 redirected from the optical splitter unit 614 through a port 223 A thereof, to the spectroscopy system 115. Unlike the parabolic reflectors 268A and 268B of the systems 200D and 200E which, in addition to reflecting and converging the optical response signal, provides a signal path for passing the aiming signal 162 (e.g., via an aperture or through-hole on the body of reflector 268A, or an anti-reflective coated surface portion on the reflector 268B), the first parabolic reflector 668 can be outside the aiming beam transmission path. The second parabolic reflector 653 has a concave surface to reflect and converge the second beam portion 118B to the power detector 150, as similarly described above with respect to the parabolic reflector 253 of systems 200D and 200E.

[0091] FIG. 7 is a schematic diagram of an exemplary computer-based clinical decision support system (CDSS) 710 that can be configured to determine a proper laser output setting based on spectroscopic data and optionally other sensor data, and / or information about the identified type or composition of the target structure, hereinafter referred to as the “input features”. In various embodiments, the CDSS 710 includes an input interface 712 through which the input features which are specific to a patient are provided to a trained ML model 714 (also referred to as an Al model) . An inference operation can be performed in which the input features are applied to the ML model 714 to generate a laser output setting as an inference output at the output interface 716. The inference output may be output to an output device 740, which may include a user interface (UI) through which the laser output setting can be communicated to a user, e.g., a clinician, or to a controller device for performing a desired action.

[0092] In some embodiments, the input interface 712 may be a direct data link between the CDSS 710 and one or more feature generating devices 730Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 that generate at least some of the input features. For example, the input interface 712 may transmit the input features directly to the CDSS 710 during a therapeutic and / or diagnostic medical procedure. Additionally, or alternatively, the input interface 712 may be a classical user interface that facilitates interaction between a user and the CDSS 710. For example, the input interface 712 may facilitate a user interface through which the user may manually enter at least some of the input features. Additionally, or alternatively, the input interface 712 may provide the CDSS 710 with access to a database of electronic patient record 720 from which one or more input features may be extracted. In any of these cases, the input interface 712 is configured to collect sensor data or features in association with a specific patient on or before a time at which the CDSS 710 is used to determine a proper laser output setting.

[0093] An inference operation can be performed using the ML model 714 to generate a proper laser output setting. For example, input interface 712 may deliver the one or more input features into an input layer of the ML model 714 which propagates these input features through the ML model 714 to an output layer. The ML model 714 can provide a computer system the ability to perform tasks, without explicitly being programmed, by making inferences based on patterns found in the analysis of data. The ML model 714 explores the study and construction of algorithms (e.g., machine-learning algorithms) that may learn from existing data and make predictions about new data. Such algorithms operate by building an ML model from example training data in order to make data-driven predictions or decisions expressed as outputs or assessments, such as determining or adjusting the laser output setting 216, as stated above.

[0094] The ML model may be trained using supervised learning or unsupervised learning. Supervised learning uses prior knowledge (e.g., examples that correlate inputs to outputs or outcomes) to learn the relationships between the inputs and the outputs. The goal of supervised learning is to learn a function that, given some training data, best approximates the relationship between the training inputs and outputs so that the ML model can implement the same relationships when given inputs to generate the corresponding outputs. Unsupervised learning is the training of an ML algorithm using information that is neither classified nor labeled, and allowing the algorithm to act on thatDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 information without guidance. Unsupervised learning is useful in exploratory analysis because it can automatically identify structure in data.

[0095] Common tasks for supervised learning are classification problems and regression problems. Classification problems, also referred to as categorization problems, aim at classifying items into one of several category values. Regression algorithms aim at quantifying some items (for example, by providing a score to the value of some input). Some examples of commonly used supervised-ML algorithms are Logistic Regression (LR), Naive-Bayes, Random Forest (RF), neural networks (NN), deep neural networks (DNN), matrix factorization, and Support Vector Machines (SVM). Examples of DNN include a convolutional neural network (CNN), a recurrent neural network (RNN), a deep belief network (DBN), or a hybrid neural network comprising two or more neural network models of different types or different model configurations.Some common tasks for unsupervised learning include clustering, representation learning, and density estimation. Some examples of commonly used unsupervised learning algorithms are K-means clustering, principal component analysis, and autoencoders.

[0096] Another type of ML is federated learning (also known as collaborative learning) that trains an algorithm across multiple decentralized devices holding local data, without exchanging the data. This approach stands in contrast to traditional centralized machine-learning techniques where all the local datasets are uploaded to one server, as well as to more classical decentralized approaches which often assume that local data samples are identically distributed. Federated learning enables multiple actors to build a common, robust machine learning model without sharing data, thus allowing to address critical issues such as data privacy, data security, data access rights and access to heterogeneous data.

[0097] The training of the ML model may be performed continuously or periodically, or in near real time as additional procedure data are made available. The training process involves algorithmically adjusting one or more ML model parameters (e.g., weights or bias at any particular layer of a neural network model), until the ML model being trained satisfies a specified training convergence criterion. By way of example and not limitation, the ML model may be trained with weighted square loss (for explicit feedback) or with binaryDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 cross-entropy loss (for implicit feedback). Other training techniques, such as deep factorization machine, wide and deep learning, deep structured semantic models, or autoencoder based recommender systems, may be used. Then, during the inference operation, the patient specific input features provided to the ML model may be propagated from an input layer, through one or more hidden layers, and ultimately to an output layer that corresponds to the laser output setting. During and / or subsequent to the inference operation, the laser output setting may be communicated to the user via the user interface (UI) and / or automatically adjusted for performing a desired action.

[0098] FIG. 8 is a flowchart illustrating an example method 800 for identifying characteristics of an anatomical target of a subject using an optical surgical system, and optionally, based on the target identification, providing treatment to the target, such as ablating a tissue target (e.g., soft tissue, hard tissue, or abnormal such as cancerous tissue) or a calculi target (e.g., kidney or pancreobiliary or gallbladder stone) using laser or other electrosurgical or electromagnetic energies. The method 800 may be implemented in and executed by the optical surgical system 110, or an embodiment thereof, such as any of the optical surgical systems 200 A, 220B, 220D, or 220E as shown in FIGS. 2 A, 2B, 2D, and 2E, respectively. As described above, the optical surgical system comprises a compact optical splitter unit and a probe coupled thereto. The compact optical splitter unit may include a single multi-purpose splitter having opposite first and second surfaces.

[0099] At step 810, an anatomical target can be illuminated using a light source, such as an LED or a Xenon light source. At step 820, an optical aiming signal, generated by an aiming source, can be redirected by the single multipurpose splitter to an optical path of the probe, such as the single multi-purpose splitter 270 as shown in shown in FIGS. 2A, 2B, 2D, and 2E. The optical aiming signal can reach the single multi-purpose splitter via optics therebetween. The optics may include, in one example, a hollow lens with an aperture (e.g., a through-hole) and a hollow reflector with an aperture (e.g., a through-hole), as illustrated in FIG. 2A. In another example, the optics may include a partially reflective optical element having an anti -reflective coated surface portion that allows the aiming beam to pass through the body portion of the optical element without significant distortion or attenuation before reaching the compact opticalDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 splitter unit, as illustrated in FIG. 2B. The anti -reflective coating can substantially lower the reflectance and increase the throughput of the aiming beam through the body of the partially reflective optical element. In yet another example, the optics may include a parabolic reflector with a “mechanical aperture” (e.g., a through-hole) or an “optical aperture” (e.g., an anti-reflective coated surface portion), as illustrated in FIGS. 2D-2E.

[0100] At step 830, the optical aiming signal can be redirected by the first surface of the single multi-purpose splitter, pass through the optical path of the probe, and ultimately reach the anatomical target. The optical aiming signal can assist in targeting and positioning the electrosurgical or electromagnetic signal at a desired location on the anatomical target.

[0101] At step 840, an electrosurgical or electromagnetic signal (also referred to as a treatment beam, such as a laser beam) generated by an energy source (such as the laser source 112 of FIG. 1) can pass through the optical splitter unit and the optical path of the probe, and is incident on the anatomical target. As the electrosurgical or electromagnetic signal passes through the optical splitter unit, it can be split by the single multi-purpose splitter into a first signal portion that travels through the splitter body and enters the optical path of the probe (and ultimately reaches the anatomical target), and a second signal portion that gets reflected by the second surface of the single multi-purpose splitter, and redirected to a power detector, where the power of the electrosurgical or electromagnetic signal, such as optical power of an optical signal (e.g., a laser beam) corresponding to one or more wavelengths or wavelength ranges per unit time, can be measured.

[0102] At step 850, at least a portion of an optical response signal, in response to illumination of the anatomical target, can be collected by a distal tip of the probe. At step 860, the collected portion of the optical response signal can travel back through the optical path of the probe, and get redirected by the first surface of the single multi-purpose splitter to a feedback analyzer, such as the spectroscopy system 115 as shown in FIGS. 2A-2B and 2D-2E.

[0103] At step 870, the collected portion of the optical response signal can be analyzed by the feedback analyzer, and a characteristic of the anatomical target can be identified. One example of the identified characteristic is a spectroscopic property of the anatomic target. In an example, the target includesDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 a calculi target, and spectral information may be used to identify the calculi target as one of a plurality of calculi types with distinct compositions, such as tones or stone fragments in various stone-forming regions such as urinary system, gallbladder, nasal passages, gastrointestinal tract, stomach, or tonsils. In an example, the calculi target may be identified as one of stone types with distinct chemical compositions, such as one of a CaP stone, a MAP stone, a COM stone, a COD stone, a cystine stone, a cholesterol-based stone, or a uric acid (UA) stone. In another example, the target includes an anatomical tissue target, and the spectral information may be used to identify the anatomical tissue target as one of a plurality of tissue types, such as soft tissue (e.g., muscles, tendons, ligaments, blood vessels, fascia, skin, fat, and fibrous tissues), hard tissue such as bone, connective tissue such as cartilage, among others. In some example, the anatomical tissue target may be identified as one of tissue types with distinct anatomical locations. For example, a renal tissue target may be identified as one of calyx tissue, cortex tissue, medulla tissue, or ureter tissue. In another example, an identified tissue target may be identified as normal tissue or abnormal tissue (e.g., cancerous tissue). In yet another example, an identified tissue target may be identified as treatment area (e.g., tumor or polyp intended for removal) or a non-treatment area (e.g., blood vessels, muscle, etc.).

[0104] At step 880, an output setting of the energy source may be adjusted based on the identified characteristics of the anatomical target. In an example, the energy source can be a laser source, and a control signal may be generated based on the identified target characteristic to adjust a laser output setting. The electrosurgical or electromagnetic signal, such as a laser beam, may be delivered to the target in accordance with the adjusted output setting. Examples of adjusting the laser settings may include delivering or withhold delivering the laser beam, or adjust a laser beam parameter such as wavelength, power, power density, energy, or a pulse parameter (e.g., pulse width, pulse rate, amplitude, duty cycle, pulse shape), exposure time, total dose or energy, or one or more combinations thereof, among others. In an example, for a calculi target or a portion thereof composed of hard material, the laser system may produce a laser beam with a higher energy to ablate or dust the target. For a calculi target or a portion thereof composed of soft material, the laser system may produce a laser beam with a lower energy to ablate or dust the target.Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02

[0105] FIG. 9 is a flowchart illustrating another example method 900 for identifying characteristics of an anatomical target of a subject using an optical surgical system, and optionally, based on the target identification, providing treatment to the target using laser or other electrosurgical or electromagnetic energies. The method 900 may be implemented in and executed by the optical surgical system 110, or an embodiment thereof, such as the optical surgical system 300 of FIG. 3A. As described above, the optical surgical system comprises a compact optical splitter unit and a probe coupled thereto. The compact optical splitter unit may include an integrated splitter assembly 310 comprising a plurality of pre-arranged optical components spatially registered to one another, such as optical prisms pre-arranged and spatially registered to one another such that any prism has a flat angled surface portion interfacing with and conforming to a flat angled surface portion of another prism, as described above with respect to FIG. 3B.

[0106] At step 910, an anatomical target can be illuminated using a light source, such as an LED or a Xenon light source. At step 920, an electrosurgical or electromagnetic signal generated by an energy source (e.g., a laser beam generated by a laser source), can be split into first and second signal portions using the integrated splitter assembly, such as the prism assembly 310 shown in FIG. 3B.

[0107] At step 930, the first signal portion split from the electrosurgical or electromagnetic signal can pass through the body of the integrated splitter assembly (e.g., a plurality of prisms) and an optical path of the probe, and irradiate the anatomical target. The second signal portion of the electrosurgical or electromagnetic signal can be redirected by at least one reflective surface portion of a first optical prism to a power detector which can measure the power of the electrosurgical or electromagnetic signal. In some examples, the second signal portion may be further redirected by a parabolic reflector spatially aligned with the first optical prism. The parabolic reflector can include a concave surface to reflect and converge the second portion of the electrosurgical or electromagnetic signal toward the power detector.

[0108] At step 940, at least a portion of an optical response signal, in response to illumination of the anatomical target, can be collected by a distal tip of the probe. At step 950, the collected portion of the optical response signal isDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 directed back through the optical path of the probe, and gets refracted and / or reflected by one or more interfacing flat angled surface portions in the integrated splitter assembly before reaching the feedback analyzer, such as the spectroscopy system 115. In some examples, the collected portion of the optical response signal can further be reflected or refracted by optics defining between the optical splitter unit and the feedback analyzer. Examples of the optics can include a mirror, or a parabolic reflector having a concave surface to reflect and converge the collected portion of the optical response signal, redirected from the integrated splitter assembly, to the feedback analyzer.

[0109] At step 960, the collected portion of the optical response signal can be analyzed by the feedback analyzer, and a characteristic of the anatomical target can be identified, similar to step 870 of method 800.

[0110] At step 970, an output setting of the energy source may be adjusted based on the identified characteristics of the anatomical target. Similar to step 880 of method 800, a control signal may be generated based on the identified target characteristic to adjust the output setting of the energy source, such as a laser output setting. The electrosurgical or electromagnetic signal, such as a laser beam, may be delivered to the target in accordance with the adjusted output setting.

[0111] Although the processes of each of the methods 800 and 900 are drawn in one flowchart, they are not required to be performed in a particular order. For example, some of the processes can be performed in a different order than that illustrated herein.

[0112] FIG. 10 illustrates generally a block diagram of an example machine 1000 upon which any one or more of the techniques (e.g., methodologies) discussed herein may perform. Portions of this description may apply to the computing framework of various portions of the optical surgical system 110, such as the spectroscopy system 115 and the power detector 150.

[0113] In alternative embodiments, the machine 1000 may operate as a standalone device or may be connected (e.g., networked) to other machines. In a networked deployment, the machine 1000 may operate in the capacity of a server machine, a client machine, or both in server-client network environments. In an example, the machine 1000 may act as a peer machine in peer-to-peer (P2P) (or other distributed) network environment. The machine 1000 may be aDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 personal computer (PC), a tablet PC, a set-top box (STB), a personal digital assistant (PDA), a mobile telephone, a web appliance, a network router, switch or bridge, or any machine capable of executing instructions (sequential or otherwise) that specify actions to be taken by that machine. Further, while only a single machine is illustrated, the term “machine” shall also be taken to include any collection of machines that individually or jointly execute a set (or multiple sets) of instructions to perform any one or more of the methodologies discussed herein, such as cloud computing, software as a service (SaaS), other computer cluster configurations.

[0114] Examples, as described herein, may include, or may operate by, logic or a number of components, or mechanisms. Circuit sets are a collection of circuits implemented in tangible entities that include hardware (e.g., simple circuits, gates, logic, etc.). Circuit set membership may be flexible over time and underlying hardware variability. Circuit sets include members that may, alone or in combination, perform specified operations when operating. In an example, hardware of the circuit set may be immutably designed to carry out a specific operation (e.g., hardwired). In an example, the hardware of the circuit set may include variably connected physical components (e.g., execution units, transistors, simple circuits, etc.) including a computer readable medium physically modified (e.g., magnetically, electrically, moveable placement of invariant massed particles, etc.) to encode instructions of the specific operation. In connecting the physical components, the underlying electrical properties of a hardware constituent are changed, for example, from an insulator to a conductor or vice versa. The instructions enable embedded hardware (e.g., the execution units or a loading mechanism) to create members of the circuit set in hardware via the variable connections to carry out portions of the specific operation when in operation. Accordingly, the computer readable medium is communicatively coupled to the other components of the circuit set member when the device is operating. In an example, any of the physical components may be used in more than one member of more than one circuit set. For example, under operation, execution units may be used in a first circuit of a first circuit set at one point in time and reused by a second circuit in the first circuit set, or by a third circuit in a second circuit set at a different time.Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02

[0115] Machine (e.g., computer system) 1000 may include a hardware processor 1002 (e.g., a central processing unit (CPU), a graphics processing unit (GPU), a hardware processor core, or any combination thereof), a main memory 1004 and a static memory 1006, some or all of which may communicate with each other via an interlink (e.g., bus) 1008. The machine 1000 may further include a display unit 1010 (e.g., a raster display, vector display, holographic display, etc.), an alphanumeric input device 1012 (e.g., a keyboard), and a user interface (UI) navigation device 1014 (e.g., a mouse). In an example, the display unit 1010, input device 1012 and UI navigation device 1014 may be a touch screen display. The machine 1000 may additionally include a storage device (e.g., drive unit) 1016, a signal generation device 1018 (e.g., a speaker), a network interface device 1020, and one or more sensors 1021, such as a global positioning system (GPS) sensor, compass, accelerometer, or other sensors. The machine 1000 may include an output controller 1028, such as a serial (e.g., universal serial bus (USB), parallel, or other wired or wireless (e.g., infrared (IR), near field communication (NFC), etc.) connection to communicate or control one or more peripheral devices (e.g., a printer, card reader, etc.).

[0116] The storage device 1016 may include a machine readable medium 1022 on which is stored one or more sets of data structures or instructions 1024 (e.g., software) embodying or utilized by any one or more of the techniques or functions described herein. The instructions 1024 may also reside, completely or at least partially, within the main memory 1004, within static memory 1006, or within the hardware processor 1002 during execution thereof by the machine 1000. In an example, one or any combination of the hardware processor 1002, the main memory 1004, the static memory 1006, or the storage device 1016 may constitute machine readable media.

[0117] While the machine-readable medium 1022 is illustrated as a single medium, the term "machine readable medium" may include a single medium or multiple media (e.g., a centralized or distributed database, and / or associated caches and servers) configured to store the one or more instructions 1024.

[0118] The term “machine readable medium” may include any medium that is capable of storing, encoding, or carrying instructions for execution by the machine 1000 and that cause the machine 1000 to perform any one or more ofDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 the techniques of the present disclosure, or that is capable of storing, encoding or carrying data structures used by or associated with such instructions. Nonlimiting machine-readable medium examples may include solid-state memories, and optical and magnetic media. In an example, a massed machine-readable medium comprises a machine readable medium with a plurality of particles having invariant (e.g., rest) mass. Accordingly, massed machine-readable media are not transitory propagating signals. Specific examples of massed machine- readable media may include: non-volatile memory, such as semiconductor memory devices (e.g., Electrically Programmable Read-Only Memory (EPROM), Electrically Erasable Programmable Read-Only Memory (EPSOM)) and flash memory devices; magnetic disks, such as internal hard disks and removable disks; magneto-optical disks; and CD-ROM and DVD-ROM disks.

[0119] The instructions 1024 may further be transmitted or received over a communication network 1026 using a transmission medium via the network interface device 1020 utilizing any one of a number of transfer protocols (e.g., frame relay, internet protocol (IP), transmission control protocol (TCP), user datagram protocol (UDP), hypertext transfer protocol (HTTP), etc.). Example communication networks may include a local area network (LAN), a wide area network (WAN), a packet data network (e.g., the Internet), mobile telephone networks (e.g., cellular networks), Plain Old Telephone (POTS) networks, and wireless data networks (e.g., Institute of Electrical and Electronics Engineers (IEEE) 802.11 family of standards known as WiFi®, IEEE 802.16 family of standards known as WiMax®), IEEE 802.15.4 family of standards, peer-to-peer (P2P) networks, among others. In an example, the network interface device 1020 may include one or more physical jacks (e.g., Ethernet, coaxial, or phonejacks) or one or more antennas to connect to the communication network 1026. In an example, the network interface device 1020 may include a plurality of antennas to wirelessly communicate using at least one of single-input multiple-output (SIMO), multiple-input multiple-output (MIMO), or multiple-input single-output (MISO) techniques. The term “transmission medium” shall be taken to include any intangible medium that is capable of storing, encoding or carrying instructions for execution by the machine 1000, and includes digital or analog communications signals or other intangible medium to facilitate communication of such software.Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02Additional Notes

[0120] 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 can be practiced. These embodiments are also referred to herein as “examples.” Such examples can include elements in addition to those shown or described. However, the present inventors also contemplate examples in which only those elements shown or described are provided. Moreover, the present 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.

[0121] In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In this document, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects.

[0122] The above description is intended to be illustrative, and not restrictive. For example, the above-described examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments can be used, such as by one of ordinary skill in the art upon reviewing the above description. The Abstract is provided to allow 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 toDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 streamline the disclosure. This should not be interpreted as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter may lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description as examples or embodiments, with each claim 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. The scope of the invention should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.

Claims

Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02What is claimed is:

1. An optical surgical system, comprising: a light source configured to generate illumination on an anatomical target; an energy source configured to generate an electrosurgical or electromagnetic signal to irradiate the anatomical target; a probe defining an optical path configured to pass (i) the electrosurgical or electromagnetic signal to the anatomical target, and (ii) an optical response signal from the anatomical target in response to illumination thereof; and an optical splitter unit coupled between the energy source and the probe, the optical splitter unit including an integrated splitter assembly comprising a plurality of pre-arranged optical components spatially registered to one another, the integrated splitter assembly configured to: split the electrosurgical or electromagnetic signal into at least first and second signal portions, and pass the first signal portion through the optical splitter unit and the optical path of the probe; and refract and / or reflect at least a portion of the optical response signal toward a feedback analyzer for identifying a characteristic of the anatomical target.

2. The optical surgical system of claim 1, wherein the integrated splitter assembly comprises a plurality of pre-arranged optical prisms spatially registered to one another such that each of the plurality of pre-arranged optical prisms has a flat angled surface portion interfacing with and conforming to a flat angled surface portion of another of the plurality of pre-arranged optical prisms.

3. The optical surgical system of claim 2, wherein the plurality of prearranged optical prisms include first and second optical prisms, the first optical prism more proximally positioned to the energy source than the second optical prism, wherein the second optical prism has a first flat angled surface portion interfacing with and conforming to a flat angled surface portion of the first optical prism, the interfacing surface portions of the first and second opticalDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 prisms configured to split the electrosurgical or electromagnetic signal into at least the first and second signal portions.

4. The optical surgical system of claim 3, wherein the first optical prism includes at least one reflective surface portion to reflect the second signal portion of the electrosurgical or electromagnetic signal to a power detector to measure a power of the electrosurgical or electromagnetic signal.

5. The optical surgical system of claim 4, further comprising a parabolic reflector spatially aligned with the at least one reflective surface portion of the first optical prism, the parabolic reflector including a concave surface configured to reflect and converge the second signal portion to the power detector.

6. The optical surgical system of any of claims 3-5, wherein the interfacing surface portions of the first and second optical prisms are further configured to reflect the at least a portion of the optical response signal to the feedback analyzer.

7. The optical surgical system of any of claims 3-6, wherein the plurality of pre-arranged optical prisms further include a third optical prism more proximally positioned to the optical path of the probe than the second optical prism, the third optical prism having a flat angled surface portion interfacing with and conforming to a second flat angled surface portion of the second optical prism, the interfacing surface portions of the second and third optical prisms configured to refract the at least a portion of the optical response signal to the interfacing surface portions of the first and second optical prisms.

8. The optical surgical system of any of claims 1-7, further comprising an aiming source configured to generate an optical aiming signal for targeting the anatomical target and assisting in positioning the electrosurgical or electromagnetic signal at the anatomical target, wherein the integrated splitter assembly is further configured to pass therethrough the optical aiming signal to the optical path.Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W029. The optical surgical system of claim 8, wherein the aiming source is configured to generate the optical aiming signal in a visible wavelength range.

10. The optical surgical system of any of claims 1-9, further comprising optics coupled between the optical splitter unit and the feedback analyzer, the optics configured to further redirect the at least a portion of the optical response signal, redirected by the integrated splitter assembly, to the feedback analyzer.

11. The optical surgical system of claim 10, wherein the optics includes a mirror.

12. The optical surgical system of claim 10, wherein the optics includes a parabolic reflector having a concave surface configured to reflect and converge the at least a portion of the optical response signal, redirected from the integrated splitter assembly, to the feedback analyzer.

13. The optical surgical system of any of claims 1-12, further comprising a fiber optic coupler coupled to the optical path of the probe, the fiber optic coupler configured to split the optical response signal into sub-portions, and to direct at least one of the sub-portions to the feedback analyzer.

14. The optical surgical system of any of claims 1-13, further comprising an optical circulator coupled to the optical path of the probe, the optical circulator configured to: transmit the at least a portion of the optical response signal to the feedback analyzer via a first pair of ports of the optical circulator; and transmit the electrosurgical or electromagnetic signal to the anatomical target via a second pair of ports of the optical circulator.

15. The optical surgical system of any of claims 1-14, wherein the energy source to emit the electrosurgical or electromagnetic signal includes a laser source to emit a treatment laser beam.Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W0216. The optical surgical system of any of claims 1-15, comprising the feedback analyzer configured to identify a spectroscopic characteristic of the anatomical target based at least in part on the at least the portion of the optical response signal.

17. The optical surgical system of any of claims 1-16, wherein the anatomical target includes a tissue target or a calculi target, and wherein the identified characteristic comprises at least one of a type, a material, a composition, a composition profile, a structure or hardness of the anatomical target.

18. The optical surgical system of any of claims 1-17, further comprising a controller circuit configured to generate a control signal to adjust an output setting of the energy source based at least in part on the identified characteristic of the anatomical target.

19. An optical surgical system, comprising: a light source configured to generate illumination on an anatomical target; an energy source configured to generate an electrosurgical or electromagnetic signal to irradiate the anatomical target; a probe including an optical path configured to pass (i) the electrosurgical or electromagnetic signal to the anatomical target, and (ii) an optical response signal from the anatomical target in response to illumination thereof; and an optical splitter unit coupled between the energy source and the probe, the optical splitter unit including an integrated splitter assembly comprising first, second, and third optical prisms pre-arranged and spatially registered to one another such that any one of the optical prisms has a flat angled surface portion interfacing with and conforming to a flat angled surface portion of another of the optical prisms, wherein: the second optical prism has a first flat angled surface portion interfacing with and conforming to a flat angled surface portion of the first optical prism, the interfacing surface portions of the first and secondDocket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 optical prisms configured to (i) split the electrosurgical or electromagnetic signal into at least the first and second signal portions, and (ii) reflect the at least a portion of the optical response signal to a feedback analyzer, the first optical prism includes at least one reflective surface portion to reflect the second signal portion of the electrosurgical or electromagnetic signal to a power detector to measure a power of the electrosurgical or electromagnetic signal; and the third optical prism having a flat angled surface portion interfacing with and conforming to a second flat angled surface portion of the second optical prism, the interfacing surface portions of the second and third optical prisms configured to refract the at least a portion of the optical response signal to the interfacing surface portions of the first and second optical prisms.

20. A method of operating an optical surgical system comprising an optical splitter unit and a probe coupled thereto to irradiate an anatomical target, the method comprising: illuminating the anatomical target using a light source; splitting an electrosurgical or electromagnetic signal, generated by an energy source, into first and second signal portions using an integrated splitter assembly of the optical splitter unit, the integrated splitter assembly comprising a plurality of pre-arranged optical components spatially registered to one another; passing the first signal portion of the electrosurgical or electromagnetic signal through the integrated splitter assembly and an optical path of the probe onto the anatomical target; collecting, via the probe, at least a portion of an optical response signal from the anatomical target in response to illumination thereof; refracting and / or reflecting the collected at least a portion of the optical response signal via the integrated splitter assembly toward a feedback analyzer; and identifying a characteristic of the anatomical target based at least in part on the collected at least a portion of the optical response signal using the feedback analyzer.Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W0221. The method of claim 20, wherein the integrated splitter assembly includes first and second optical prisms pre-arranged and spatially registered to each other such that the second optical prism has a first flat angled surface portion interfacing with and conforming to a flat angled surface portion of the first optical prism, wherein splitting the electrosurgical or electromagnetic signal into at least the first and second signal portions is via the interfacing surface portions of the first and second optical prisms.

22. The method of claim 21, further comprising: redirecting the second portion of the electrosurgical or electromagnetic signal to a power detector via at least one reflective surface portion of the first optical prism; and measuring a power of the electrosurgical or electromagnetic signal based at least in part on the redirected second signal portion.

23. The method of claim 22, further comprising: positioning a parabolic reflector such that a concave surface thereof faces the at least one reflective surface portion of the first optical prism; and reflecting and converging the second signal portion of the electrosurgical or electromagnetic signal to the power detector.

24. The method of any of claims 21-23, wherein refracting and / or reflecting the collected at least a portion of the optical response signal to the feedback analyzer includes reflecting the at least a portion of the optical response signal to the feedback analyzer via the interfacing surface portions of respective first and second optical prisms.

25. The method of any of claims 21-24, wherein the integrated splitter assembly further include a third optical prism, the third optical prism having a flat angled surface portion interfacing with and conforming to a second flat angled surface portion of the second optical prism,Docket No.: 5409.957WO1Client Ref No.: GAP25001-URKT-W02 wherein refracting and / or reflecting the collected at least a portion of the optical response signal to the feedback analyzer includes: refracting the at least a portion of the optical response signal via the interfacing surface portions of respective second and third optical prisms; and directing the refracted at least a portion of the optical response signal to the interfacing surface portions of the first and second optical prisms.

26. The method of any of claims 20-25, further comprising: passing an optical aiming signal, generated by an aiming source, through the integrated splitter assembly of the optical splitter unit; and directing the optical aiming signal through the optical path of the probe and onto an anatomical target to assist in positioning the electrosurgical or electromagnetic signal at the anatomical target.

27. The method of any of claims 20-25, wherein refracting and / or reflecting the collected at least a portion of the optical response signal includes reflecting and converging the collected at least a portion of the optical response signal using a parabolic reflector.

28. The method of any of claims 20-27, further comprising: coupling a fiber optic coupler to the optical path of the probe; feeding the collected at least a portion of the optical response signal to the fiber optic coupler to split it into sub-portions of signal; and directing at least one of the signal sub-portions to the feedback analyzer.

29. The method of any of claims 20-28, further comprising: coupling an optical circulator to the optical path of the probe; transmitting the at least a portion of the optical response signal to the feedback analyzer via a first pair of ports of the optical circulator; and transmitting the electrosurgical or electromagnetic signal to the anatomical target via a second pair of ports of the optical circulator.

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