Methods and apparatus for a stone fragment suction device. An apparatus includes a steerable access sheath having a proximal end and a distal end, a tip at the distal end, and a suction conduit positioned within a central lumen of the steerable access sheath from the distal end to the proximal end, the steerable access sheath containing an outer lumen surrounding the central lumen with one or more channels therethrough, an outer circumference of the outer lumen and an outer circumference of the central lumen forming concentric circles, the steerable access sheath further including a radiopaque material at the distal end or along a length of the steerable access sheath to enable tracking with a remote fluoroscopic device.