System and method for guided removal from an in vivo subject

A method for removing an object, comprising:

• inserting a sheath into an in vivo passageway of a subject;
• inserting a device through the sheath;
• positioning the device adjacent to the object;
• using the device to break the object into a plurality of smaller objects;
• removing the device;
• guiding, subsequent to removal of the device, a flexible tube having an external diameter of at least about 11 French through the sheath, wherein the flexible tube comprises at least a first passageway and a second passageway;
• positioning a distal end of the first passageway adjacent to the plurality of objects;
• infusing saline solution through the second passageway while suction is off;
• and
• removing the plurality of objects through the first passageway with at least a portion of the saline solution.