Medical systems are described, including a medical system that includes a sheath with at least one lumen configured to be coupled to a suction source, an irrigation device that includes at least one irrigation lumen configured to be coupled to an irrigation source, and a medical device that includes a handle and a shaft. The shaft may include a working channel with a distal opening, one or more illumination devices, and one or more visualization devices. The medical device may be configured to be positioned within the sheath during delivery of the sheath to a treatment site and during an application of energy to break up one or more objects to form one or more particles or dust. The irrigation device may be configured to be positioned within the sheath and deliver irrigation fluid while suction is applied to the treatment site.