Abstract: Insufflation is currently considered to be a necessary part of an endoscopic procedure. However, it introduces risks and costs that would be beneficial to eliminate. The endoscopic assistance devices and methods disclosed herein facilitate the performance of endoscopic procedures without insufflation. The devices attach directly or indirectly to the distal end portion of the endoscope. One or more resilient, curved bars extend from the attachment point around an internal void space to form a resilient, curved cage that spreads tissue gently during the advance of the endoscope. The resilient, curved bars define the windows of the cage that enable the visualization of the internal anatomy via a lens on the distal face of the endoscope and the passage of treatment devices from the operative channel of the endoscope.