In accordance with some configurations, systems and methods for guided removal from an in vivo subject are provided. In some configurations, a method for removing an object is provided. The method comprising, guiding a flexible tube through an in vivo subject's ureter, 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 object. Infusing saline solution through the second passageway while suction is off. Removing the object through the first passageway with at least a portion of the saline solution.
