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 a passageway of an in vivo subject, wherein the flexible tube comprises at least a first passageway and a second passageway. Positioning a distal end of the first passageway in proximity to the object. Infusing liquid through the second passageway substantially continuously. Removing the object through the first passageway with at least a portion of the liquid while suction is not being provided.