Ureterscope devices and systems having a fiber tip position sensor

A method of using a laser fiber with an ureteroscope, the method comprising:

• inserting a catheter of the ureteroscope into a urethra of a subject to a selected position;
• feeding the laser fiber into a working channel port on a handpiece of the ureteroscope and through a working channel positioned at least partially in the handpiece and the catheter and in fluid communication with the working channel port;
• determining if an emitting end on the laser fiber is outside the working channel and spaced at least a predetermined distance from a working channel opening in a distal end of the catheter distal to the handpiece using one or more sensors and a processor in communication with the one or more sensors, wherein determining if the emitting end on the laser fiber is outside the working channel and spaced at least the predetermined distance from the working channel includes at least determining if the emitting end on the laser fiber is outside the working channel and spaced at least the predetermined distance from the working channel opening using the processor and data from an image sensor positioned at the distal end of the catheter that detects at least a portion of the laser fiber has exited the working channel through the working channel opening by determining an amount of the laser fiber visible on a display displaying in real time the images collected from the image sensor;
• and
• emitting a laser light from the emitting end of the laser fiber if the emitting end on the laser fiber is determined to be outside the working channel and spaced at least the predetermined distance from the working channel.

A ureteroscope system, comprising:

• a handpiece having a distal end region, a proximal end region, an interior region, a working channel port, a first portion of a working channel in fluid communication with the working channel port, and a cable port;
• a catheter extending from the distal end region of the handpiece, the catheter including a second portion of the working channel in fluid communication with the working channel port and the first portion of the working channel, a distal end defining a working channel opening in fluid communication with the working channel;
• one or more sensors positioned and configured to detect a position of at least a portion of a laser fiber;
• and
• a processor in communication with the one or more sensors and configured to determine if an emitting end of the laser fiber configured to emit laser light is outside the working channel and spaced at least a predetermined distance from the distal end of the catheter such that laser light emitting from the emitting of the laser fiber does not damage the catheter and/or the handpiece,
• wherein the one or more sensors include at least one sensor positioned to detect the laser fiber or a jacket on the laser fiber entering the working channel and/or passing through the working channel with at least some of the first portion of the working channel passing through the interior region of the handpiece and being translucent or transparent, and with the at least one sensor being positioned in the interior region of the handpiece at least proximate to the first portion of the working channel that is translucent or transparent, the at least one sensor being configured to detect the laser fiber or the jacket on the laser fiber passing through the first portion of the working channel that is translucent or transparent.

A method of using a laser fiber with an ureteroscope, the method comprising:

• inserting a catheter of the ureteroscope into a urethra of a subject to a selected position;
• feeding the laser fiber into a working channel port on a handpiece of the ureteroscope and through a working channel positioned at least partially in the handpiece and the catheter and in fluid communication with the working channel port;
• determining if an emitting end on the laser fiber is outside the working channel and spaced at least a predetermined distance from a working channel opening in a distal end of the catheter distal to the handpiece using one or more sensors and a processor in communication with the one or more sensors, wherein determining if the emitting end on the laser fiber is outside the working channel and spaced at least the predetermined distance from the working channel includes at least detecting the laser fiber or a jacket on the laser fiber entering the working channel port and/or passing through the working channel with at least one sensor positioned proximate to the working channel port and/or the working channel and determining if the emitting end on the laser fiber is outside the working channel and spaced at least the predetermined distance from a working channel opening using the processor and data from the at least one sensor detecting the laser fiber or the jacket on the laser fiber;
• and
• emitting a laser light from the emitting end of the laser fiber if the emitting end on the laser fiber is determined to be outside the working channel and spaced at least the predetermined distance from the working channel.