According to one aspect, a medical device may include a shaft including a distal tip with a distal-facing surface. The shaft also may include a fluid lumen extending to the distal tip and a nozzle at a distal end of the fluid lumen. The nozzle may be configured to emit a fluid jet from the distal tip. The shaft also may include a vacuum lumen extending to the distal tip and a vacuum chamber at the distal tip. The vacuum lumen may open into the vacuum chamber, and the vacuum chamber may be wider than the vacuum lumen. The shaft may further include a vacuum opening, and the vacuum chamber may open into the vacuum opening. The vacuum opening may be defined by the distal-facing surface of the distal tip.