US20040019358A1 - Medical device - Google Patents

Abstract

A stone retrieval suction device facilitates the retention and then relocation and/or removal of objects disposed in a patient's urinary system. The device includes an elongated member for placement in a channel of a flexible ureteroscope. The elongated member defines a suction passageway which extends longitudinally therethrough. The elongated member is flexible enough to bend with the flexible ureteroscope, and it is strong enough to prevent collapse of the suction passageway when suction is provided through the suction passageway by a vacuum source. The elongated member includes a distal portion for contacting and retaining an object when the suction is provided.

Description

TECHNICAL FIELD
• The invention relates generally to medical devices.[0001]
BACKGROUND INFORMATION
• Typical stone retrieval devices are used for retrieving objects, such as kidney stones, that are disposed in easily-accessed areas of a patient's urinary tract. Some known stone retrieval devices are configured such that a physician must advance the device past the object, deploy a basket, and then pull the device back toward the object to capture the object in the basket. In situations where the object is embedded in tissue or located in a lower calyx of a patient's kidney, the device cannot be advanced beyond the object and therefore cannot capture the object. Stone retrieval devices configured with graspers can be used to try to retrieve stones embedded in tissue or located in the lower calyx. These devices typically are not very flexible, however, and therefore frequently are not useful in reaching and capturing such objects. Further, grasping stone retrieval devices may not be able to retrieve a certain object due to the size and/or shape of that object.[0002]
SUMMARY OF THE INVENTION
• Objects, such as kidney stones and other natural or foreign materials, can become trapped in a patient's urinary system. These objects can be disposed in areas of the urinary system which are not easily accessed by currently available stone retrieval devices. The present invention relates to medical retrieval devices and related methods for accessing and then retaining, relocating, and/or removing an object disposed in an internal location of a patient's body (such as the urinary system) which is not easily accessed by currently available retrieval devices.[0003]
• In one aspect, the invention involves a medical device. The medical device includes an elongated member that is configured for placement in a channel of a flexible ureteroscope. The elongated member defines a suction passageway which extends longitudinally therethrough. The elongated member bends with the flexible ureteroscope when placed within the channel of the flexible ureteroscope. The suction passageway resists collapsing when suction is provided through the suction passageway by a vacuum source. The elongated member includes a proximal portion for communicating with the vacuum source to provide the suction through the suction passageway and a distal portion for contacting an object and retaining the object in contact with the distal portion when the suction is provided through the suction passageway.[0004]
• Embodiments according to this aspect of the invention can include various features. For example, the distal portion can include a tapered tip. The distal portion can include a tip which includes a concave portion for contacting the object and retaining the object in contact with the concave portion when the suction is provided through the suction passageway. The distal portion can include a tip which includes a plurality of members extending radially outward from the tip. The plurality of members prevent tissue proximate to the object from being drawn into the suction passageway when suction is provided through the suction passageway. The distal portion can include a tip which includes a concave portion. The concave portion prevents tissue proximate the object from being drawn into the suction passageway when the suction is provided through the suction passageway. The elongated member can include a mesh to reinforce the member and thus resist collapse of the suction passageway when suction is provided. The mesh can extend longitudinally and circumferentially along the elongated member. The mesh can include stainless steel. The elongated member can include a coil which extends longitudinally and circumferentially along the elongated member. The proximal portion can include a luer connector and/or a handle for connecting to the vacuum source. The handle can include a switch for selectively enabling and disabling the suction through the suction passageway. The proximal portion can be in communication with a regulator for regulating the suction through the suction passageway. The elongated member can be made of a material such as a biocompatible plastic, a biocompatible polyurethane, or a biocompatible rubber, for example. The elongated member can have an outside diameter of between two and three french. At least some of the distal portion can be radiopaque.[0005]
• In another aspect, the invention involves a method of contacting and moving an object disposed in a patient. The method includes providing a vacuum source, providing a flexible ureteroscope and introducing the ureteroscope into a patient, and providing a medical device. The medical device includes an elongated member that is configured for placement in a channel of the flexible ureteroscope. The elongated member defines a suction passageway extending longitudinally therethrough. The elongated member bends with the ureteroscope when the elongated member is placed within the channel of the flexible ureteroscope. The suction passageway resists collapsing when suction is provided through the suction passageway by the vacuum source. The elongated member includes a proximal portion for communicating with the vacuum source to provide the suction through the suction passageway, and a distal portion for contacting an object and retaining the object in contact with the distal portion when the suction is provided through the suction passageway. The method further includes introducing the medical device into the channel of the flexible ureteroscope, providing suction through the suction passageway and retaining the object in contact with the distal portion, and moving the retained object from a first location in the patient to a second location.[0006]
• Embodiments according to this aspect of the invention can include various features. For example, the method can further include moving the retained object to a second location. Moving the retained object to a second location can include moving the retained object outside the patient or to another location inside the patient.[0007]
• The foregoing and other objects, aspects, features, and advantages of the invention will become more apparent from the following description and from the claims.[0008]
BRIEF DESCRIPTION OF THE DRAWINGS
• In the drawings, like reference characters generally refer to the same parts throughout the different views. Also, the drawings are not necessarily to scale, emphasis instead generally being placed upon illustrating the principles of the invention.[0009]
• FIG. 1A is an illustrative diagram of a stone retrieval suction device, according to one embodiment of the invention.[0010]
• FIG. 1B is an illustrative cross sectional view of the stone retrieval suction device of FIG. 1A, taken along line B-B in FIG. 1A.[0011]
• FIG. 2 is an illustrative diagram of a flexible ureteroscope disposed in a patient and a stone retrieval suction device in communication with a vacuum source disposed outside of the patient, according to one embodiment of the invention.[0012]
• FIG. 3 is an illustrative diagram of the stone retrieval suction device of FIG. 2 partially disposed in a channel of the flexible ureteroscope.[0013]
• FIG. 4A is an illustrative diagram of the stone retrieval suction device of FIG. 2 disposed in the channel of the flexible ureteroscope and extending out of a distal end of the ureteroscope and into the patient's kidney.[0014]
• FIG. 4B is an illustrative diagram of a stone retrieval suction device disposed in the channel of the flexible ureteroscope and also in communication with a remote vacuum source through an extension tube, according to another embodiment of the invention.[0015]
• FIG. 5 is an illustrative cross sectional view of a distal portion of a stone retrieval suction device disposed inside the patient and proximate an object disposed in the patient's kidney, according to one embodiment of the invention.[0016]
• FIG. 6 is an illustrative cross sectional view of the distal portion of the stone retrieval suction device of FIG. 5 contacting and retaining the object disposed in the patient's kidney.[0017]
• FIG. 7 is an illustrative cross sectional view of the distal portion of the stone retrieval suction device of FIG. 6 after the object disposed in a patient's kidney has been relocated.[0018]
• FIG. 8 is an illustrative cross sectional view of the distal portion of the stone retrieval suction device of FIG. 7 after the object disposed in a patient's kidney has been released.[0019]
• FIG. 9 is an illustrative cross sectional view of the distal portion of the stone retrieval suction device of FIG. 7 removing the object from the patient's kidney.[0020]
• FIG. 10A is an illustrative diagram of a stone retrieval suction device including a mesh, according to another embodiment of the invention.[0021]
• FIG. 10B is an illustrative cross sectional view of the stone retrieval suction device of FIG. 10A, taken along line B-B in FIG. 10A, according to one embodiment of the invention.[0022]
• FIG. 10C is an illustrative cross sectional view of the stone retrieval suction device of FIG. 10A, taken along line B-B in FIG. 10A, according to another embodiment of the invention.[0023]
• FIG. 10D is an illustrative cross sectional view of the stone retrieval suction device of FIG. 10A, taken along line B-B in FIG. 10A, according to still another embodiment of the invention.[0024]
• FIG. 11A is an illustrative diagram of a stone retrieval suction device including a coil, according to one embodiment of the invention.[0025]
• FIG. 11B is an illustrative cross sectional view of the stone retrieval suction device of FIG. 11A, taken along line B-B in FIG. 11A, according to one embodiment of the invention.[0026]
• FIG. 11C is an illustrative cross sectional view of the stone retrieval suction device of FIG. 11A, taken along line B-B in FIG. 11A, according to another embodiment of the invention.[0027]
• FIG. 11D is an illustrative cross sectional view of the stone retrieval suction device of FIG. 11A, taken along line B-B in FIG. 11A, according to still another embodiment of the invention.[0028]
• FIG. 12 is an illustrative cross sectional view of a tapered tip coupled to a distal portion of the stone retrieval suction device, according to one embodiment to the invention.[0029]
• FIG. 13A is an illustrative cross sectional view of a tip including a concave portion coupled to a distal portion of the stone retrieval suction device, according to another embodiment to the invention.[0030]
• FIG. 13B is an illustrative cross sectional view of a tip including a concave portion coupled to a distal portion of the stone retrieval suction device, according to yet another embodiment to the invention.[0031]
• FIG. 14 is an illustrative cross sectional view of a tip including a plurality of arms extending radially outward coupled to a distal portion of the stone retrieval suction device, according to still another embodiment to the invention.[0032]
• FIG. 15 is an illustrative cross sectional view of a tapered tip coupled to a distal portion of the stone retrieval suction device including a mesh disposed on the inner surface of a wall of the elongated member, according to one embodiment to the invention.[0033]
• FIG. 16 is an illustrative cross sectional view of a tip including a concave portion coupled to a distal portion of the stone retrieval suction device including a mesh disposed in a wall of the elongated member, according to another embodiment to the invention.[0034]
• FIG. 17 is an illustrative cross sectional view of a tip including a plurality of arms extending radially outward coupled to a distal portion of the stone retrieval suction device including a mesh disposed on the outer surface of a wall of the elongated member, according to still another embodiment to the invention.[0035]
• FIG. 18 is an illustrative cross sectional view of a tapered tip coupled to a distal portion of the stone retrieval suction device including a coil disposed on the inner surface of a wall of the elongated member, according to one embodiment to the invention.[0036]
• FIG. 19 is an illustrative cross sectional view of a tip including a concave portion coupled to a distal portion of the stone retrieval suction device including a coil disposed in a wall of the elongated member, according to another embodiment to the invention.[0037]
• FIG. 20 is an illustrative cross sectional view of a tip including a plurality of arms extending radially outward coupled to a distal portion of the stone retrieval suction device including a coil disposed on the outer surface of a wall of the elongated member, according to still another embodiment to the invention.[0038]
• FIG. 21 is an illustrative diagram of the stone retrieval suction device including a handle disposed in the channel of the flexible ureteroscope and extending out of a distal end of the ureteroscope and into the patient's kidney.[0039]
• FIGS. 22A and 22B are illustrative cross sectional diagrams of a handle of the stone retrieval suction device, according to one embodiment of the invention.[0040]
• FIGS. 23A and 23B are illustrative cross sectional diagrams of a handle of the stone retrieval suction device, according to another embodiment of the invention.[0041]
• FIG. 24A is an illustrative diagram of a handle of the stone retrieval suction device, according to still another embodiment of the invention.[0042]
• FIGS. 24B and 24C are illustrative cross sectional diagrams of the handle shown in FIG. 24A.[0043]
DESCRIPTION
• Objects, such as kidney stones (calculi) and other natural or foreign materials, can become trapped in a patient's urinary system. These objects can be disposed in areas of the urinary system that are easily accessed by currently available stone retrieval devices. These objects can also be disposed in areas of the urinary system, such as embedded in tissue or located in a lower calyx of a patient's kidney, for example, which are not easily accessed by currently available stone retrieval devices. The present invention relates to medical devices and related methods for accessing and then retaining, relocating, and/or removing an object disposed in an internal area of a patient's body (such as the urinary system) which is difficult or impossible to access with currently available retrieval devices or methods.[0044]
• Referring to FIGS. 1A and 1B, in one embodiment, the stone[0045]retrieval suction device100 includes anelongated member102 which defines asuction passageway110 extending longitudinally therethrough. Theelongated member102 is designed to be placed in a channel of a flexible ureteroscope and has an outside diameter of between two and three french. Theelongated member102 bends with the flexible ureteroscope when placed within the channel of the flexible ureteroscope. Thesuction passageway110 resists collapsing when suction is provided through thesuction passageway110 by a vacuum source. For example, theelongated member102 can be reinforced to resist collapse of thesuction passageway110 when suction is provided through thesuction passageway110. Materials that can be used for theelongated member102 include, but are not limited to, biocompatible plastic, biocompatible rubber, and biocompatible polyurethane. In one embodiment, the bendableelongated member102 is formed of Pebax, PTFE, or Polyuethane. The elongated member further includes aproximal portion108. Theproximal portion108 is in communication with the vacuum source to provide suction through thesuction passageway110. In one embodiment, theproximal portion108 can also include aluer connector104. Theluer connector104 is used to connect theelongated member102 to the vacuum source. The elongated member further includes adistal portion106 for making contact with an object disposed in a patient, such as a kidney stone. Thedistal portion106 retains the object in contact with thedistal portion106 when suction is provided through thesuction passageway110. In one embodiment, thedistal portion106 can also include a taperedtip112 which is used to contact the object. In other embodiments, thedistal portion106 can include other types of tips which are discussed in further detail below. In some embodiments, thedistal portion106 can also include a radiopaque material which facilitates easily locating theelongated member102 with a fluoroscope when theelongated member102 is disposed within the patient. The radiopaque material can be painted on, and/or embedded in, theelongated member102. The radiopaque material can also be a band painted on, embedded in, and/or wrapped around thedistal portion106 of theelongated member102. In some embodiments, the radiopaque material can be tungsten filled ink, bismuth subcarbonate, or barium sulfate. In other embodiments, the radiopaque material can be a platinum or tantalum metal band.
• The[0046]elongated member102 can be extruded from any of the materials previously described using known extrusion techniques. Theluer connector104 can be made of molded plastic or metal, such as stainless steel. The taperedtip112 can also be made of molded plastic or metal.
• Referring to FIGS.[0047]2-4A, in operation, a user (e.g. a doctor or other medical personnel) inserts adistal end216 of aflexible ureteroscope214 into the patient'surethra202. The user advances theflexible ureteroscope214 so that thedistal end216 passes into and through theurinary bladder204, into and through theureter206, and into thekidney208. The user positions thedistal end216 of theflexible ureteroscope214 within the patient'skidney208 by manipulatingpositioning knobs230,232. Theknob230 moves thedistal end216 vertically and theknob232 moves thedistal end216 horizontally. By manipulating the positioning knobs230,232, and viewing the kidney's208 interior with aneyepiece224, the user can position adistal channel opening228 of theflexible ureteroscope214 proximate an object, such as a kidney stone, that is disposed in the patient'skidney208.
• The user then connects the[0048]luer connector104 to aregulator210 which, in turn, is connected to avacuum source212. Thevacuum source212 provides suction through thesuction passageway110 and theregulator210 allows the user to vary the suction provided by thevacuum source212 by adjusting asuction adjustment dial222. In this embodiment, thevacuum source212 is located near the patient. In another embodiment, thevacuum source212 can be located remotely and is discussed in further detail below.
• As previously described, the[0049]elongated member102 includes a material that enables theelongated member102 to bend with theflexible ureteroscope214. After the user has inserted theflexible ureteroscope214 into the patient, the user then inserts thedistal portion106 of theelongated member102 into aproximal channel opening226 at aproximal end218 of theflexible ureteroscope214. The user then advances thedistal portion106 through the channel502 (shown in FIG. 5) of theflexible ureteroscope214 until the taperedtip112 extends out of thedistal channel opening228 at thedistal end216 of theflexible ureteroscope214.
• Referring to FIG. 4B, in another embodiment, the[0050]elongated member102 can be connected to a remotely located vacuum source212 (such as a vacuum source located on a wall). In this embodiment, theelongated member102 communicates with theregulator210 through anextension tube402. Theluer connector104 of theelongated member102 is mated to afirst luer connector406 disposed on aproximal end408 of theextension tube402. Asecond luer connector404 disposed on adistal end410 of the extension tube is connected to theregulator210.
• Referring to FIGS. 4A, 5, and[0051]6, after theelongated member102 is advanced through thechannel502 so that the taperedtip112 extends out of thechannel502 through thedistal channel opening218 and is proximate to akidney stone504, the user switches on the suction (using switch220). The suction pulls thekidney stone504 in a direction (indicated by arrow506) toward the taperedtip112. Eventually, thekidney stone504 makes contact with the taperedtip112 and is held in contact with the taperedtip112 by the continuous suction through the suction passageway110 (shown in FIG. 1B). If thekidney stone504 is embedded in tissue, the user moves the taperedtip112 toward the embeddedkidney stone504. After the taperedtip112 makes contact with the embeddedkidney stone504, the suction through thesuction passageway110 retains thekidney stone504 in contact with the taperedtip112. The user can then pull thekidney stone504 free by retracting thedistal portion106 of theelongated member102 into thechannel502.
• This device and method enables the user to capture and retain the[0052]kidney stone504 even when thekidney stone504 is embedded in tissue or located in a portion of the patient's body that is difficult or impossible to access with typical basket and/or grabber stone retrieval devices.
• Referring to FIGS.[0053]7-8, after contacting and retaining thekidney stone504, the user can reposition thedistal end216 of theflexible ureteroscope214 with thedistal portion106 of theelongated member102 still extending beyond thedistal channel opening218 and retaining thekidney stone504 in contact with the taperedtip112. The purpose of repositioning thedistal end216 of theflexible ureteroscope214 is to move thekidney stone504 to an area in the kidney that is easily accessed by typical stone retrieval baskets or grabbers. After the user relocates thekidney stone504, the user can release thekidney stone504 by discontinuing the suction and retracting thedistal portion106 of theelongated member102 through thedistal channel opening218. After thekidney stone504 is released, the user can use any of a variety of existing stone retrieval devices to capture and remove thekidney stone504 from the patient's urinary system. If thekidney stone504 is too large to remove, the user can employ any of a variety stone destruction devices (such as laser or vibration devices, for example) to break thekidney stone504 into smaller pieces. If thekidney stone504 has a diameter smaller than the diameter of thechannel502 of theflexible ureteroscope214, the user can remove thekidney stone504 from the patient by pulling thekidney stone504 through thechannel502 of theflexible ureteroscope214.
• Referring to FIGS.[0054]10A-D and15-17, in another embodiment, the stoneretrieval suction device100 includes amesh1002 which extends longitudinally and circumferentially along theelongated member102. Themesh1002 can be made of stainless steel and/or other material(s). Themesh1002 can be, for example, formed by two or more cords that are woven together to form themesh1002 with each cord having one or more, for example three or more, component strands. Each of the strands could be thin wire or metal or a metal alloy, for example. Themesh1002 reinforces theelongated member102 so that theelongated member102 does not collapse when suction is provided through thesuction passageway110 by the vacuum source212 (FIG. 4A). The cords of themesh1002 can be either spaced closely together to form a dense mesh or spaced far apart to form a sparse or open mesh. Themesh1002 can be affixed to an inner surface1006 (FIGS. 10C and 15) or an outer surface1004 (FIGS. 10B and 17) of theelongated member102. Themesh1002 can also be embedded between theinner surface1006 and theouter surface1004 of the elongated member102 (FIGS. 10D and 16).
• Referring to FIGS.[0055]11A-D and18-20, in still another embodiment, the stoneretrieval suction device100 includes acoil1102 which extends circumferentially and longitudinally along theelongated member102. Thecoil1102 can be made of stainless steel and/or other material(s). Thecoil1102 can be, for example, formed by a cord with the cord having one or more, for example three or more, component strands. Each of the strands could be thin wire or metal or a metal alloy, for example. Thecoil1102 reinforces theelongated member102 so that theelongated member102 does not collapse when suction is provided through thesuction passageway110 by a vacuum source. Thecoil1102 can be tightly wound so that the individual coils are spaced closely together to form a dense coil or thecoil1102 an be loosely wound so that the individual coils are spaced far apart to form an open coil. As with themesh1002, thecoil1102 can be affixed to the inner surface1006 (FIGS. 11C and 18) or the outer surface1004 (FIGS. 11B and 20) of theelongated member102. Thecoil1102 can also be embedded between theinner surface1006 and theouter surface1004 of the elongated member102 (FIGS. 11D and 19).
• Referring to FIG. 12, the[0056]distal portion106 of theelongated member102 can include a taperedtip112. The taperedtip112 can be made of molded plastic or metal, for example, although other materials or combinations of materials are possible. In another embodiment shown in FIG. 13A, thedistal portion106 can include atip1302 with aconcave portion1304. Theconcave portion1304 is used to contact an object disposed in a patient's urinary system and retain the object in contact with theconcave portion1304 when suction is provided through thesuction passageway110. In still another embodiment shown in FIG. 13B, thedistal portion106 can include aconcave portion1306 with a taperedtip1308 within theconcave portion1306. Theconcave portion1306 is used to keep surrounding tissue away from the suction in the taperedtip1308 when the taperedtip1308 contacts an object. In yet another embodiment shown in FIG. 14, thedistal portion106 can include atip1402 which includes a plurality ofmembers1404. The plurality ofmembers1404 extend radially outward from thetip1402 and prevent tissue (proximate to an object being contacted) from being pulled into thesuction passageway110. Thetips1302,1402 can also be made of molded plastic or metal.
• Referring to FIGS. 21, 22A, and[0057]22B, in another embodiment, thesuction retrieval device100 can include ahandle2102. Thehandle2102 includes asuction button2104 which is used to enable and disable the suction in thesuction passageway110 by uncrimping and crimping a portion of theelongated member102 disposed in thehandle2102. When thesuction button2104 is not pressed (default position), thesuction button2104 is positioned such that arigid member2108 presses against the suction tube302 thereby crimping theelongated member102 and disabling the suction in thesuction passageway110.
• When the[0058]suction button2104 is pressed (in the direction indicated by arrow2106), thesuction button2104 is positioned such that therigid member2108 no longer crimps theelongated member102, thereby enabling suction in thesuction passageway110. As long as thesuction button2104 is pressed, the suction in thesuction passageway110 is enabled. As soon as thesuction button2104 is released, the suction in thesuction passageway110 is disabled.
• In operation, after inserting the[0059]flexible ureteroscope214 into the patient's urinary system, the user connects theluer connector104 to theregulator210 and then guides theelongated member102 into and through the channel of theflexible ureteroscope214. The user then turns on thevacuum source212 with theswitch220 and adjusts the suction withsuction adjustment knob222 on theregulator210. The user positions theelongated member102 proximate to an object disposed in the patient's urinary system by the method previously described, and then presses thesuction button2104 on thehandle2102 to engage the suction (by uncrimping the portion ofelongated member102 disposed in the handle2102). After the object is captured and relocated to a new position or removed from the patient, the user releases thebutton2104 to disengage the suction (by crimping the portion ofelongated member102 disposed in the handle2102) thereby releasing the object.
• Referring to FIGS. 23A and 23B, in still another embodiment, the[0060]suction retrieval device100 can include ahandle2302. Thehandle2302 includes asuction port2306 which is used to enable and disable the suction in thedistal portion106 of thesuction passageway110. Thesuction port2306 is an opening to thesuction passageway110 and allows outside air to be sucked into thesuction passageway110 by the vacuum source (as indicated by arrows2304) when left open or uncovered. As a result, the suction in thedistal portion106 of thesuction passageway110 is significantly reduced or disabled entirely. When thesuction port2306 is covered, by a user'sfinger2308 for example, thesuction port2306 is sealed and the suction in thedistal portion106 of thesuction passageway110 is restored.
• Referring to FIGS.[0061]24A-C, in yet another embodiment, thesuction retrieval device100 can include ahandle2402. Thehandle2402 includes arotatable valve2404 which is used to enable and disable the suction in thedistal portion106 of thesuction passageway110 by redirecting the suction from the vacuum source. Thevalve2404 includes a handle2412 (for rotating the valve) and twoperpendicular suction tubes2416,2414. When thevalve2404 is rotated to an open position (FIG. 24B), asuction port2406 is put in communication with the vacuum source via thesuction tubes2414,2416. Outside air is pulled through thesuction port2406, through thesuction tubes2414,2416, and into thesuction passageway100 by a vacuum source as indicated byarrow2408. The suction in thedistal portion106 of thesuction passageway110 is thereby disabled. When thevalve2404 is rotated to a closed position (FIG. 24C), thesuction port2406 is sealed and thedistal portion106 of thesuction passageway110 is put in communication with the vacuum source viasuction tube2414. The suction in thesuction passageway110 is thereby enabled as indicated byarrows2410.
• Variations, modifications, and other implementations of what is described herein may occur to those of ordinary skill in the art without departing from the spirit and scope of the invention. Accordingly, the invention is not to be defined only by the preceding illustrative description.[0062]

Claims (21)

What is claimed is:

1. A medical device, comprising:

an elongated member for placement in a channel of a flexible ureteroscope, the elongated member defining a suction passageway extending longitudinally therethrough, the elongated member bending with the flexible ureteroscope when the elongated member is placed within the channel of the flexible ureteroscope, the suction passageway resists collapsing when suction is provided through the suction passageway by a vacuum source, the elongated member comprising:

a proximal portion for communicating with the vacuum source to provide the suction through the suction passageway; and

a distal portion for contacting an object and retaining the object in contact with the distal portion when the suction is provided through the suction passageway.

2. The medical device ofclaim 1 wherein the distal portion comprises a tapered tip.

3. The medical device ofclaim 1 wherein the distal portion comprises a tip comprising a concave portion for contacting the object and retaining the object in contact with the concave portion when the suction is provided through the suction passageway.

4. The medical device ofclaim 1 wherein the distal portion further comprises a tip comprising a plurality of members extending radially outward from the tip to prevent tissue proximate the object from entering the suction passageway when the suction is provided through the suction passageway.

5. The medical device ofclaim 1 wherein the distal portion further comprises a tip comprising a concave portion to prevent tissue proximate the object from entering the suction passageway when the suction is provided through the suction passageway.

6. The medical device ofclaim 1 wherein the elongated member further comprises a mesh to reinforce the elongated member and resist collapse of the suction passageway when the suction is provided through the suction passageway.

7. The medical device ofclaim 6 wherein the mesh extends longitudinally and circumferentially along the elongated member.

8. The medical device ofclaim 6 wherein the mesh comprises stainless steel.

9. The medical device ofclaim 1 wherein the elongated member further comprises a coil extending longitudinally and circumferentially for reinforcing the elongated member and resisting collapse of the suction passageway when the suction is provided through the suction passageway.

10. The medical device ofclaim 1 wherein the proximal portion further comprises a luer connector.

11. The medical device ofclaim 1 wherein the proximal portion communicates with a regulator for regulating the suction through the suction passageway.

12. The medical device ofclaim 1 wherein the elongated member comprises a biocompatible plastic.

13. The medical device ofclaim 1 wherein the elongated member comprises a biocompatible polyurethane.

14. The medical device ofclaim 1 wherein the elongated member comprises a biocompatible rubber.

15. The medical device ofclaim 1 wherein the elongated member has an outside diameter of between two and three french.

16. The medical device ofclaim 1 wherein the proximal portion further comprises a handle.

17. The medical device ofclaim 16 wherein the handle comprises a switch for selectively enabling and disabling the suction through the suction passageway when the proximal portion is in communication with the vacuum source.

18. The medical device ofclaim 1 wherein the distal portion comprises a radiopaque material.

19. A method of contacting and moving an object disposed in a patient, comprising:

providing a vacuum source;

providing a flexible ureteroscope and introducing the ureteroscope into the patient;

providing a medical device comprising:

an elongated member for placement in a channel of the flexible ureteroscope, the elongated member defining a suction passageway extending longitudinally therethrough, the elongated member bending with the flexible ureteroscope when the elongated member is placed within the channel of the flexible ureteroscope, the suction passageway resists collapsing when suction is provided through the suction passageway by the vacuum source, the elongated member comprising:

a proximal portion for communicating with the vacuum source to provide the suction through the suction passageway; and

a distal portion for contacting an object and retaining the object in contact with the distal portion when the suction is provided through the suction passageway;

introducing the medical device into the channel of the flexible ureteroscope;

positioning the flexible ureteroscope to allow the distal portion to contact the object;

providing suction through the suction passageway and retaining the object in contact with the distal portion; and

moving the retained object from a first location in the patient to a second location.

20. The method ofclaim 19 wherein moving the retained object to the second location comprises moving the retained object outside of the patient.

21. The method ofclaim 19 wherein moving the retained object to the second location comprises moving the retained object to another location in the patient.

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