Stone fragment suction device

An apparatus comprising:

• a steerable access sheath, the steerable access sheath comprising:
• a proximal end, a distal end, a tip at the distal end, a central lumen, and an outer lumen surrounding the central lumen;
• a suction conduit positioned within the central lumen disposed from the distal end to the proximal end;
• the outer lumen having one or more channels therethrough;
• at least a portion of the one or more channels being fluid flow channels;
• the one or more fluid flow channels extending from the proximal end to the distal end, the one or more fluid flow channels including one or more targeted exit conduits and in fluid communication with the one or more fluid flow channels proximal to the tip, and the one or more targeted exit conduits having exit pathways oriented to create a directed flow at the distal tip, wherein the one or more fluid flow channels are configured to generate turbulence within a region of interest.