Abstract: Devices for and methods of treating afflictions occurring in a body cavity, such as the epidural space. The methods and devices provide for fluoroscopic assisted placement of a fiber optic catheter/scope with a balloon tip. These devices and methods would perform decompression surgery, neuroplasty, and mechanical lysis of adhesions (and other afflictions), as well as allowing small operating and therapeutic instruments under direct visualization.

Abstract: An endoscopic apparatus including an internal unit, adapted to be advanced into a gastrointestinal tract of a patient so as to enable inspection of the tract, an anchor unit, adapted to be held in a position outside the gastrointestinal tract and a flexible sleeve, having a proximal end fixed to the anchor and a distal end fixed to the internal unit, wherein at least a portion of the sleeve between the proximal end distal ends is held initially in a compact state at the internal unit and is arranged to feed out from the internal unit as the internal unit is advanced into the gastrointestinal tract. A method for endoscopic examination is also disclosed.

Abstract: A guide device for an endoscope includes a plurality of tubular members that are configured to be inflated and collapsed. The plurality of tubular members are arranged and joined to form a composite tubular configuration defining a lumen. The guide device is configured to receive an endoscope within the lumen and guide the endoscope along a path within an organ.

Abstract: A guide device for an endoscope includes a tubular member that is configured to be inflated and collapsed. The tubular member includes a plurality of straight portions, a plurality of looped portions, and a plurality of manipulable portions. The guide device is configured to receive an endoscope and guide the endoscope along a path within an organ.

Abstract: A balloon control apparatus includes a balloon, a flow rate adjustment section, a setting section and a control section. The balloon is attached to an insertion section of an endoscope and/or an insertion aid instrument for guiding insertion of the insertion section of the endoscope. The flow rate adjustment section adjusts an air supply flow rate to the balloon and/or an exhaust flow rate from the balloon. The setting section sets the air supply flow rate and/or the exhaust flow rate. The control section controls the flow rate adjustment section so that the air supply flow rate to the balloon and/or the exhaust flow rate from the balloon become the air supply flow rate and/or the exhaust flow rate set by the setting section.

Abstract: An overtube for an endoscope includes a tube body, a balloon, a first-communication-path, a second-communication-path, a first-mouthpiece, a second-mouthpiece, a first-connection-section which is provided on the first-mouthpiece, and a second-connection-section which is provided on the second-mouthpiece. The balloon is dilatably/deflatably provided on the tube body. The first-communication-path extends from a distal-end-portion toward a proximal-end-portion of the tube body in a state in which the first-communication-path communicates with the balloon. The second-communication-path extends from a hollow-portion toward the proximal-end-portion of the tube body. The first-mouthpiece projects from the tube body and includes a path communicating with the first-communication-path. The second-mouthpiece projects from the tube body and includes a path communicating with the second-communication-path.

Abstract: Endoscopic apparatus, including a probe (9) having an anterior component (12) and a posterior component (14), and a flexible dual-sleeved tube (31). The flexible dual-sleeved tube consists of a flexible external sleeve (26) and a flexible internal sleeve (36) within the external sleeve. The sleeves are coupled between the anterior component and the posterior component so as to define an enclosure (37) between the sleeves, which enclosure is inflated in order to propel the anterior component within a lumen (49).

Abstract: A method for withdrawing a fluid sample from a patient is disclosed comprising the steps of: a) providing a sampling device (10) having a housing (20) and a needle (40) having a sharpened tip for piercing the skin of the patient; b) withdrawing fluid from the patient into the housing; c) retracting the needle so that the sharpened tip of the needle is enclosed within the housing; and d) expelling the fluid from the housing after the needle is retracted.

Abstract: An endoscope system with a hollow cylinder and bellows moving mechanism is provided. The system includes a cylinder having a head unit mounted by a camera devices, a front fixing unit connected to the head unit which is installed to an outer circumference of the cylinder and fixed to an inner wall of an organ, a rear fixing unit slidably installed at the outer circumference of the cylinder and fixed to the inner wall of the organ, and a moving unit between the front fixing unit and the rear fixing unit for moving the head unit in the organ by an extension and contraction when the front fixing unit or the rear fixing unit fixes the head unit to the inner wall of the organ. The moving unit includes a double bellows and forms a hermetic space with the outer circumference surface of the cylinder.

Abstract: An imaging system comprising an imaging device assembled on a carrier tube, and a first outwardly expandable element and a second outwardly expandable element mounted on the carrier tube, wherein the second expandable element is expandable both radially and axially, the imaging system comprising a mode of operation, wherein during expansion of the second expandable element, obstruction of the radial expansion of the second expandable element causes the axial expansion of the second expandable element to propel the carrier tube and the imaging device axially.

Abstract: An endoscopic apparatus including an internal unit, adapted to be advanced into a gastrointestinal tract of a patient so as to enable inspection of the tract, an anchor unit, adapted to be held in a position outside the gastrointestinal tract and a flexible sleeve, having a proximal end fixed to the anchor and a distal end fixed to the internal unit, wherein at least a portion of the sleeve between the proximal end distal ends is held initially in a compact state at the internal unit and is arranged to feed out from the internal unit as the internal unit is advanced into the gastrointestinal tract. A method for endoscopic examination is also disclosed.

Abstract: An apparatus for locating morphological features within a body cavity includes a catheter including proximal and distal ends, a transparent balloon carried on the distal end, and an optical imaging assembly carried on the distal end for imaging through the balloon. The balloon includes a channel extending therethrough to a lumen extending through the catheter. A guidewire or other localization member is received in the lumen that is extendabe through the channel. During use, the catheter is inserted into a right atrium of a heart, and the balloon is expanded and placed against the wall of the heart to locate the coronary sinus. Sufficient force is applied to clear blood between the surface and the wall and clear the field of view of the imaging assembly. The catheter is manipulated to locate the coronary sinus, whereupon the localization member is advanced into the coronary sinus.

Abstract: The present invention includes systems and methods for decreasing the pain and discomfort commonly associated with endoscopic procedures, where such procedures may be performed with lower dosage levels of sedative and analgesic drugs. The invention includes use of an anesthetic collar coupled to an endoscope with a flexible shaft. The anesthetic collar allows lubricants, local anesthetics, dyes, and/or other desirable fluids to be passed through the existing lumen of the flexible shaft into an annulus, where the fluid may be distributed through expulsion pores into the gastrointestinal tract.

Abstract: The dilation balloon of the subject invention preferably comprises a balloon portion mounted about a shaft that, when inflated, produces a configuration comprising a tapered distal end and a proximal end or butt that is substantially flat (preferably truncated) and is adapted to generally conform with the outer contours of an endoscope through which it is introduced when the balloon is pulled back against the endoscope face. The close engagement of the subject balloon catheter and endoscope, when forming a balloon-scope train, enables the scope to more readily navigate strictures and tortuous body lumen, as well as allows the balloon to act as a lens for viewing anatomical structure within the body lumen, such as tumors, strictures, and the inner luminal wall surface itself.

Abstract: An in-vivo device, such as an autonomous imager or other suitable in-vivo device, includes a moveable arm, extendible element, or proboscis. The in-vivo device may include sensors, such as imagers, etc. The device may transmit sensing information via, for example, wireless transmission, or wired transmission.

Abstract: The present invention relates to an endoscope shaft comprising a movable distal end portion which is bendable by means of an operating device, the distal end portion having at least one decentralized hose member extending along the distal end portion, said hose member being integrally formed of a plurality of directly superimposed expansion bellows and forming a continuous pressure chamber so as to expand in the longitudinal direction when pressure is applied.

Abstract: Elongate flexible sheath (2) for being driven into position along a body cavity of a patient by an instrument (4) such as an endoscope. Sheath has a closed front end region (10) blocking passagc in longitudinal direction and an opposite rear end region. In form of inflatable balloon, at least a section (18) of front end region transparent to enable viewing into body cavity for endoscope or other driving examination instrument. Sheath provided with one or more conduits (20, 22) lying along balloon and opening to exterior of balloon at front end region enabling fluid delivery, suction, or access of an implement into body cavity. Methods of positioning sheath in body cavity.

Abstract: A cannula fixation system that allows for easy insertion and removal. A flexible sleeve with corrugations and proximal flange is attached distally to the cannula. The flange serves as a splashguard and a finger retention device. The corrugations have a variable diameter depending upon the tension applied to the proximal flange. The flange is pulled proximally to reduce the diameter of the corrugations for insertion of the cannula. Upon release of the flange, the corrugations expand because of the inherent resiliency of the sleeve to seal against the portal in the patient. The cannula body can be shifted with the sleeve remaining in sealing contact with the portal.

Abstract: The present invention provides methods and apparatus for pleating at least a portion of a patient's body lumen, such as the colon. Pleating is achieved via relative motion between an endoscope and a flexible conduit having an engagement element configured to reversibly engage the body lumen.

Abstract: Apparatus and methods are provided for placing and advancing a diagnostic or therapeutic instrument in a hollow body organ of a tortuous or unsupported anatomy, comprising a handle, an overtube, a distal region having an atraumatic tip. The overtube may be removable from the handle, and have a longitudinal axis disposed at an angle relative to the handle. The overtube may be selectively stiffened to reduce distension of the organ caused by advancement of the diagnostic or therapeutic instrument. The distal region permits passive steering of the overtube caused by deflection of the diagnostic or therapeutic instrument while the atraumatic tip prevents the wall of the organ from becoming caught or pinched during manipulation of the diagnostic or therapeutic instrument.

Abstract: Expandable actuators surround a central conduit. Each actuator comprises a bladder that, when fluid is introduced, expands laterally while contracting longitudinally. A restorative spring can be placed inside a bladder and between the two ends to restore the actuator to its original shape as fluid is withdrawn. Multiple actuators can be placed in series to successively inflate and deflate and generate a peristaltic motion. One or more Shape Memory Alloy (SMA) springs can be affixed to one or more restorative springs to cause bending motion.

Abstract: Instruments for thermally-mediated treatment of a patient's lower esophageal sphincter (LES) to induce an injury healing response to thereby populate the extracellular compartment of walls of the LES with collagen matrices to altere the biomechanics of the LES to provide an increased intra-esophageal pressure for preventing acid reflux. A preferred embodiment is a bougie-type device for trans-esophageal introduction that carries conductive electrodes for delivering Rf energy to walls of the LES (i) to induce the injury healing response or (ii) to “model” collagenous tissues of the LES by shrinking collagen fibers therein. Typically, an Rf source is connected to at least one conductive electrode that may be operated in a mono-polar or bi-polar fashion. A sensor array of individual sensors is provided in the working end.

Abstract: A centering mechanism accurately centers a probe as it moves through a pathway having a changing shape, diameter, and direction. More specifically, the invention provides a probe centering device that includes a ring shaped resilient balloon, a front stopper that fixes a location of a first side of the balloon, and a biasing mechanism that applies a biasing force to a second side of the balloon. The biasing mechanism includes a rear stopper, a spring and a pusher, wherein the spring is located between the rear stopper and the pusher and the pusher is in contact with the second side of the balloon. A flexible member is preferably provided to cover and protect the biasing mechanism.

Abstract: A device for moving a tool along a passage, particularly for use in medical procedures, has two different aspects. In one aspect, a tool, e.g. a colonoscope, is surrounded by a sheath. The sheath has an inflatable region for engaging the passage wall, e.g. a colon. An annular extension region of the sheath is provided which becomes part of the inflated inflatable region thereby increasing its length as the fluid pressure acts against a head of a tool to draw the tool along the passage. The annular extension region has sheath parts which face one another by their relative orientation caused by crumpling of the extension region, or the sheath parts are provided by folded portions. The extension region moves together with the tool as the sheath parts sequentially move into the inflated inflatable region. In the other aspect, after inflation of the inflatable region of the sheath, inflation pressure acts against an inflatable head carried at the distal end region of the tool to draw the tool along the passage.

Abstract: A surgical instrument includes a working sheath and an obturator. A method is also described for facilitating endoscopic examination and surgical procedures using such an instrument. The sheath is an elongated self-supporting tube with a lumen of sufficient size to accommodate other-surgical instruments. During use, the instrument is placed in the body percutaneously or through a body passage with the removable obturator located in the lumen to facilitate insertion of the sheath into the body. Once inserted, the obturator can be removed. The sheath is held in place by an inflatable bulb provided on the distal end of the sheath while the operation is being completed. A peripheral duct is also preferably provided for introducing anesthetic or lubricant during insertion.

Abstract: An endoscope apparatus has a side view endoscope 10 for side viewing an object in a radial direction of a distal end constitutional portion 14 and a balloon catheter 40. With an insert portion 13 of a side view endoscope 10 inserted in an insert tube 41 of the balloon catheter 40, the balloon catheter 40 is inserted into a blood vessel B. The insert tube 41 is provided at its distal end with a transparent balloon 42. This balloon 42 encloses the distal end constitutional portion 14. By feeding air (fluid) to this balloon 42, the balloon 42 is expanded so as to be urged against an inside wall of the blood vessel B. This causes the blood to be discharged between the inside wall of the blood vessel B and the balloon 42, thus enabling to observe the inside wall of the blood vessel B through the side view endoscope 10.

Abstract: A catheter system is provided that permits easy cannulation and radiological examination of the biliary and pancreatic ducts during an Endoscopic Retrograde Cholangiopancreatograhy (ERCP) procedure. The system of biliary catheters provides for a method of gaining access to the biliary tree, particularly when the contralateral wall or septum of the biliary tree interferes with access to the biliary tree. This anatomical interference is remedied using a pulling biliary catheter that withdraws the papilla of Vater away from the contralateral wall or septum by pulling proximally upon a chute expanded within the papilla of Vater. The enlarged opening then permits additional medical devices to be advanced through the pulling biliary catheter into the desired duct requiring the ERCP procedure.

Abstract: Expandable actuators surround a central conduit. Each actuator comprises a bladder that, when fluid is introduced, expands laterally while contracting longitudinally. A restorative spring can be placed inside a bladder and between the two ends to restore the actuator to its original shape as fluid is withdrawn. Multiple actuators can be placed in series to successively inflate and deflate and generate a peristaltic motion. One or more Shape Memory Alloy (SMA) springs can be affixed to one or more restorative springs to cause bending motion.

Abstract: An insertion facilitating device for an intestinal endoscope has a cylindrical body in which an insertion portion of an endoscope for a large intestine is inserted while holding an anal sphincter of a patient in an open position. The cylindrical body is provided at one end thereof with a conical opening.

Abstract: The hysteroscope port includes a cylindrical cannula dimensioned for insertion through a vagina to penetrate a cervix. A balloon element having a nonsmooth surface is positioned adjacent the distal end of the cannula for dilating the cervix and for maintaining the cervix in a dilated state. The balloon is inflatable between a narrowed insertion and withdrawal position and an expanded dilatation position. An introducer's distal portion is dimensioned for insertion through the cannula's lumen and is sufficiently long to extend beyond the cannula's distal end. The introducer's distal tip is tapered and smooth for ease of insertion. The introducer's proximal portion protrudes from the cannula's proximal opening for being grasped for insertion into and removal from the cannula.

Abstract: Endoscopic apparatus which advances within a lumen (40) includes a probe (20) having distal and proximal ends and a flexible sleeve (26) coupled proximally to the probe. The sleeve is inflated in order to propel the probe within the lumen. The probe typically includes an imaging device (28), which captures images inside the lumen.

Abstract: A centering mechanism accurately centers a probe as it moves through a pathway having a changing shape, diameter, and direction. More specifically, the invention provides a probe centering device that includes a ring shaped resilient balloon, a front stopper that fixes a location of a first side of the balloon, and a biasing mechanism that applies a biasing force to a second side of the balloon. The biasing mechanism includes a rear stopper, a spring and a pusher, wherein the spring is located between the rear stopper and the pusher and the pusher is in contact with the second side of the balloon. A flexible member is preferably provided to cover and protect the biasing mechanism.

Abstract: A laparoscopic port adapter assembly 10 for conducting bile duct and related procedures, including a laparoscopic port 11, an introducer sheath 12 and a multiple conduit instrument guide 13. The instrument guide 13 may be inserted into a bile duct 14 to facilitate concurrent introduction of multiple instruments directly into the bile duct 14 without need for forceps manipulation of instruments through additional laparoscopic ports. The procedure may be conducted and viewed in real-time video to improve procedural efficiency and safety. Inventive related useful instruments and procedures are included to complement use and flexibility of the laparoscopic port adapter assembly 10. A preferred embodiment may include use of a three-conduit instrument guide 13 and concurrent introduction of a lithotripter 32, choledochoscope 31 and irrigative catheter 34 directly in the bile duct 14.

Abstract: An enhanced endotracheal tube utilizing a fiber optic bundle positioned in its wall section to transmit light and a reflectively coated bore to transmit images is disclosed. Additional passages formed in the wall of the endotracheal tube are adapted to receive a stylette and to act as an air passage for inflating an inflatable cuff formed on the inner end of the endotracheal tube. The light transmitted through the fiber optic bundle aids in illuminating the patient's laryngeal area and the image is reflected along the reflectively coated bore to aid the physician in intubating the patient. Alternative embodiments using a bore with a sleeve having a different refractive index from that of the tube material and an enhanced endotracheal tube for use with children are shown.

Abstract: An endoscope apparatus has a side view endoscope 10 for side viewing an object in a radial direction of a distal end constitutional portion 14 and a balloon catheter 40. With an insert portion 13 of a side view endoscope 10 inserted in an insert tube 41 of the balloon catheter 40, the balloon catheter 40 is inserted into a blood vessel B. The insert tube 41 is provided at its distal end with a transparent balloon 42. This balloon 42 encloses the distal end constitutional portion 14. By feeding air (fluid) to this balloon 42, the balloon 42 is expanded so as to be urged against an inside wall of the blood vessel B. This causes the blood to be discharged between the inside wall of the blood vessel B and the balloon 42, thus enabling to observe the inside wall of the blood vessel B through the side view endoscope 10.

Abstract: An optical feeding tube includes an elongated sheath having a first lumen for delivering nutrients to a gastrointestinal tract and an imaging device disposed in a second lumen. The imaging device provides visualization of an area adjacent a distal end of the elongated sheath. The imaging device can be an optical fiber extending from a proximal end to a distal end of the elongated sheath. The optical feeding tube can also include a retention device. The method for placing the feeding tube involves passing the feeding tube through an opening in the abdominal wall and into a gastro-intestinal tract while observing a passageway ahead of the feeding tube.

Abstract: A hood for an endoscope which is detachably mounted near a distal end portion of the endoscope. The hood has a balloon adapted to be expanded into a substantially cylindrical configuration by injecting a fluid into the balloon, and to be contracted by discharging the fluid out of the balloon. A visual field of the endoscope can be secured by expanding the balloon, and can be prevented from being shaded by contracting the balloon.

Abstract: A directionally expandable standoff device for use with an imaging instrument is disclosed. The standoff device has an elastic sheath configured for placement over a probe of an imaging instrument and a substantially rigid cover configured for placement over the elastic sheath, the cover containing an opening exposing a portion of the elastic sheath. The standoff device allows controlled positioning of the tissue surface within the cavity of a patient's body during imaging analysis.

Abstract: An endoscope has an anchoring and positioning device, in the form of an inflatable balloon, at its distal end section. The distal end of the endoscope has a section length, a major peripheral part, and a minor peripheral part. The inflatable balloon, being shaped as a cradle, circumscribes the major peripheral part of the distal end section. A window section is located on the minor peripheral part. The balloon is capable of spacing the window section from a wall of a passage surrounding the endoscope, thereby providing a good view and sufficient working space for the operation of the endoscope. A catheter to flow a fluid in and out of the balloon is coupled to the balloon.

Abstract: A probe for a speculum for use in examining the interior of a body cavity. The probe comprised an elongated tubular member (1) having a first and second end and an expandable sealing element (2) encircling said tubular member at or near the first end (3). A means for admission of a fluid (50) is provided to the interior of said sealing element to effect expansion thereof. A removable closure means is adapted to engage the second end (30). A means for admission of a fluid into the bore of said tubular member is also provided (32). The closure means provides a line of sight and extending there through and along the bore of the tubular member.

Abstract: A medical device introduction system, a medical introducer, and related methods are provided. The medical device introduction system preferably includes a medical introducer having an introducer body and a plurality of lumen formed therein, an imaging device positioned in a predetermined one of the plurality of lumen of the medical introducer so that the imaging device is separately controllable independent of the medical introducer, and a separate steerable working channel device positioned in at least one other of the plurality of lumen of the medical introducer so that the separate steerable working channel device and the imaging device are separately controllable by a user thereof independent of each other. The separate steerable working channel device preferably includes an elongate tube portion having at least one lumen formed therein which defines the working channel and steering means associated with the elongate tube portion for steering the elongate tube portion.

Abstract: A bending sheath for a probe being inserted in a channel of a forceps of an endoscope inserted in a body cavity of a patient for observing the diseased part thereof is disclosed. The bending sheath comprises a hollow sheath, at least one extended portion extending in the sheath axis direction from the sheath tip portion, and a tip holding member for holding detachably the inserted tip portion of the probe inserted in the sheath.

Abstract: An endoscope which is both flexible and easily cleaned having a pair of telescoping sections at its distal end one of which carries a camera and which are alternately actuated to provide movement through a body passageway by a Bowden type of cable. Such cable has an outer helical casing with an inner steel wire. Respectively attached to the two cylindrical sections are inflatable bladders which provide for the movement above which also are an integral part of the flexible sterilized sheath being held to the respective sections by O-rings.

Abstract: A surgical dissector and method for facilitating fiberoptic viewing when developing a minimally invasive accessway to a surgical objective in the interior of the body. The dissector or guide is used to dissect tissues along an anatomic plane under direct fiberoptic vision. A balloon is provided to further dissect and retract tissue along the dissected accessway to provide an adequate depth of field for fiberoptic viewing through transparent walls of the balloon. The dissection allows a surgeon safely to make additional incisions into the region of the fiberoptic viewing space and to perform surgical procedures under fiberoptic vision by manipulating an accessory instrument on the exterior surface of the inflated balloon that is disposed within the dissected space.

Abstract: An endoscope has an anchoring and positioning device, in the form of an inflatable balloon, at its distal end section. The distal end of the endoscope has a section length, a major peripheral part, and a minor peripheral part. The inflatable balloon, being shaped as a cradle, circumscribes the major peripheral part of the distal end section. A window section is located on the minor peripheral part. The balloon is capable of spacing the window section from a wall of a passage surrounding the endoscope, thereby providing a good view and sufficient working space for the operation of the endoscope. A catheter to flow a fluid in and out of the balloon is coupled to the balloon.

Abstract: The cuff on the patient end of a tracheal tube is attached at one end to the inside of the tube and at the opposite end to the outside of the tube. The cuff encloses an axial sleeve that is slidably mounted within the patient end of the tube and is urged forwardly by a resilient collar. The sleeve can be retracted by applying vacuum to the cuff and, when released, extends forwards to prevent the cuff occluding the patient end of the tube.

Abstract: An expandable multifunctional instrument for creating a space at an obstructed site in the body includes an elongate member having a distal end for being introduced in the body, a proximal end for being disposed externally of the body and an expandable member for being positioned at the obstructed site. The expandable member is movable at the obstructed site from a non-expanded position to an expanded position to displace anatomical tissue to create a space at the obstructed site for performing various operative procedures. A method of creating a space at an obstructed site includes expanding an expandable member at the obstructed site and/or introducing fluid under pressure at the obstructed site to create a space where normally no space exists.

Abstract: A surgical dissector and method for facilitating fiberoptic viewing when developing a minimally invasive accessway to a surgical objective in the interior of the body. The dissector or guide is used to dissect tissues along an anatomic plane under direct fiberoptic vision. A balloon is provided to further dissect and retract tissue along the dissected accessway to provide an adequate depth of field for fiberoptic viewing through transparent walls of the balloon. The dissection allows a surgeon safely to make additional incisions into the region of the fiberoptic viewing space and to perform surgical procedures under fiberoptic vision by manipulating an accessory instrument on the exterior surface of the inflated balloon that is disposed within the dissected space.

Abstract: A robot for performing endoscopic procedures in flexible and curved human or animal lumens. A plurality of segments are attached to each other. Traction segments embrace the lumen walls. Other segments include actuators that cause the endoscope to locally deform its shape via bending, extending, or some combination of bending and extension. A method is provided to sequence the action of the segments to cause inchworm-like or snake-like locomotion, or a combination of them through a curved and flexible lumen. The method of movement can be adapted to the lumen characteristics, or to obviate a component failure. A compressed gas line attached to the back segment provides compressed gas for insufflation of the lumen, and can optionally be used to drive the actuators that control the operation of the endoscope segments. The lead segment may include television cameras, ultrasound transducers, biopsy arms, drug delivery systems, or other sensors, diagnostic aids, therapeutic devices, and surgical tools.

Abstract: The present invention is an endoscopic over-tube for receiving and guiding medical instrumentation into the upper alimentary canal of a patient. The endoscopic over-tube has a bite block for insertion and retention in the mouth of the patient. The endoscopic over-tube also has a flexible protective sheath engaging the bite block and adapted for insertion into the upper alimentary canal of the patient. The sheath includes a stiffened region that insulates the posterior wall of the patient's pharynx from medical instrumentation as the medical instrumentation is intubated through the sheath and into the patient's alimentary canal.