Abstract: Laparoscopic instruments and cannulas are provided for performing laparoscopic procedures entirely through the umbilicus. Generally S-shaped laparoscopic instruments placed through the C-shaped trocar sleeves or through the cannula and instrument holder unit provide markedly improved degrees of instruments' freedom during trans-umbilical laparoscopic procedures.

Abstract: Systems and methods for treating spinal stenosis include endoscopic access devices and bone removal devices used to perform a foraminotomy or other bone removal procedures. A bone removal device includes a cannulotome with an endoscopic imaging lumen. Optionally, an endoscope retaining device can be used to facilitate advancement of the endoscope through the cannulotome.

Abstract: An arthroscopic inflow and outflow sheath providing an improved inflow and outflow system reducing the diameter of a continuous flow system while providing fluid management during arthroscopy. The improved arthroscopic inflow and outflow sheath comprises an elongated atraumatic tube having an inner surface, outer surface, proximal end, and distal end. The atraumatic sheath further comprises a plurality of ribs extending from the inner surface of the tube and designed to contact an outer surface of the arthroscope thereby creating outer lumens facilitating the inflow and outflow of fluid to a surgical site. The distal tip of the tube is made of an elastic material having a higher modulus of elasticity than the modulus of elasticity in the material of the proximal end of the tube.

Abstract: Using a guidance system with a simple configuration, propulsive motion along a longitudinal direction and changing of the propulsion direction are easily performed with good precision and stability. There is provided a capsule-type medical apparatus which is inserted into the body of a subject and is guided by an external magnetic field, the capsule-type medical apparatus comprising: a substantially cylindrical capsule; a propulsion mechanism for converting rotary motion about a longitudinal axis R of the capsule into propulsive motion along the longitudinal axis R; a magnet accommodated inside the capsule and disposed in such a manner that the magnetic-pole direction thereof can be switched between a direction along the longitudinal axis R and a direction intersecting the longitudinal axis R; and a securing portion for securing the magnet to the capsule in each of the switched states of the magnetic-pole direction.

Abstract: Described herein are various systems and methods for directing endoscopy instruments to varying positions at a target site. In one aspect, at least one instrument channel has multiple exit points at the distal end of the guide tube, and the position of an instrument delivered through the channel may be switched between the different exit points. In another aspect, an instrument channel splits into multiple branches at the distal end of the guide tube, and the position of an instrument at the target site may be changed by selectively directing the instrument into a different channel branch. In yet another aspect, the guide tube, or a portion thereof, may be rotated to reposition an instrument at the target site. The capability of changing the instrument positions during a procedure would enable a physician to examine or treat multiple target sites within an operative field, without necessitating the full retraction of the instruments or the guide tube from the operative field.

Abstract: A guiding system includes a capsule medical device including a permanent magnet; a magnetic field generating unit to generate a magnetic field to the magnet to guide the capsule, and change a direction of the magnetic field in a three-dimensional space; and a control unit to control the magnetic field generated by the generating unit. Where the capsule is located on a liquid surface, the control unit generates a first magnetic field such that a plane, which is parallel to a vertical axis and in which a magnetic field including a rotating magnetic field where a magnetic field is rotated on the plane is generated, pivots about the vertical axis at a predetermined period and a second magnetic field for generating a magnetic attracting force for moving the magnet vertically downward to submerge the capsule in the liquid, the first and second magnetic fields being applied at a same time.

Abstract: An endoscope includes an outer tube having a sharpened distal end and a retractable sleeve slidably disposed in the outer tube. An image conduit is attached to the distal end of the retractable sleeve for imaging any object in contact with the distal tip of the image conduit.

Abstract: Provided is a medical treatment endoscope including: an endoscope main body which includes an elongated insertion portion having a lumen and an image capturing mechanism disposed in a distal end of the insertion portion; an arm which is able to be inserted into or extracted from the lumen and has a treatment tool lumen for allowing an endoscope treatment tool to be inserted therethrough; and a positioning mechanism which positions a part of the arm inserted through the lumen with respect to the endoscope main body.

Abstract: A medical device such as an endoscope, a laparoscope, or other device including an entry guide uses outriggers or arms that are mounted on the distal end of the entry guide and rotationally deployed to provide separation of instruments when the entry guide reaches a work site. Deployment can be implemented with as few as one cable or actuator to operate the arms. This mechanism may achieve working separation in a short axial length without complicating instrument channels that may be used for other instruments introduced through the entry guide.

Abstract: An insertion device includes a support member supporting a rotating tubular member between a base member and the rotating tubular member in diametrical directions and holding the rotating tubular member at a position where a rotation driving force is transmittable from a driving unit to an inner peripheral portion of the rotating tubular member connected to the driving unit. The insertion device includes a distal side ring member maintaining liquid-tightness between an outer peripheral portion of the base member and the inner peripheral portion of the rotating tubular member to a distal direction side of the driving unit placement cavity, and a proximal side ring member maintaining liquid-tightness between the outer peripheral portion of the base member and the inner peripheral portion of the rotating tubular member to a proximal direction side of the driving unit placement cavity.

Abstract: A dilator may include a substantially conical body having a tip portion at a proximal end and a base portion at a distal end thereof. A wire lock portion may be configured to lock a guide wire to the dilator. A voice prosthesis holding portion may be connected to the substantially conical body by a connecting portion. The holding portion may have a central passage configured to have a tubular body of a voice prosthesis positioned therethrough, wherein at least one flange of the prosthesis is substantially unfolded proximally of the central passage.

Abstract: A dissection device comprising an elongate cannula having proximal and distal ends and a central axis and arranged to receive at least a remote viewing device therein, a handle arranged to be attached to the proximal end of the elongate cannula and a dissection tip arranged to be attached to the distal end of the elongate cannula, the dissection tip comprising a curved hollow shroud that when the dissection tip is orientated for use defines a substantially concave working cavity having an open underside, the hollow shroud comprising a pair of laterally extending lateral extensions, each wing extending from an opposing lateral portion of the periphery of the hollow shroud.

Abstract: A speculum assembly includes a tubular shaped housing having a first open end, a second end open and a peripheral wall extending between the first and second ends. A tubular shaped bladder has an open forward end, an open rear end and a perimeter wall extending between the forward and rear ends. The rear end is attached to and is coextensive with the second end so that the bladder extends forward of the second end of the housing. The bladder is inflatable and flares outwardly from the rear end to the forward end when the bladder is inflate. A pump apparatus is fluidly coupled to the bladder. The pump apparatus is adapted for inflating the bladder so that the bladder extends outwardly away from the housing. A sleeve is mounted to the housing and covers the bladder when the bladder is deflated.

Abstract: A colonoscopy or enema aide is described which decreases friction or “rub” on the anus. Specifically, the colonoscope or enema tube is placed through the device which is then inserted into the rectum. The device prevents air from escaping. The device comprises a circular base and a conical section extending from the base to a tip through which the scope or tube is passed during use.

Abstract: A non-rebreathing oxygen mask for supplying a continuous flow of oxygen to a patient. The non-rebreathing oxygen mask includes a face mask portion for enclosing the mouth and nose of a patient, an oxygen reserve bag for receiving a supply of oxygen from an external source, and an intermediate oxygen entry port for regulating the flow of oxygen into the oxygen reserve bag from an external source. The mask further includes a closeable aperture through which an endoscope or larger sized medical instrument may be inserted, and an auxiliary tube for monitoring carbon dioxide exhalation by the patient.

Abstract: A face mask that may be used for bag-mask ventilation, during the induction of general anesthesia for example, and allows for two-handed or ambidextrous use. The face mask includes a dome connected to a deformable rim, which forms an enclosed air space when the rim is pressed against a patient's face. The dome has a connection port and a contoured outer surface adjacent the connection port. The contoured outer surface includes contour features such as a pair of crossed composite recesses which may each receive a different one of a user's thumbs. The connection port is aligned with the patient's mouth when the mask is in use and an adapter may be included that attaches to the connection port and provides a ventilation port as well as an intubation port that is aligned with the mouth.

Abstract: A linear body drive device capable of safely and reliably operating a linear body is provided. A linear body insertion device includes a drive portion, an operation portion, a sensor portion and a processing portion serving as a measurement portion, and an output portion serving as a notification portion. The drive portion drives a linear body having flexibility. The operation portion includes an input member (an operation lever) operated by an operator for controlling performance of the drive portion. The sensor portion included in the measurement portion detects compressive force in a direction of longitudinal axis applied to the linear body, based on a degree of bending of the linear body driven by the drive portion. The output portion provides notification of data of compressive force detected by the measurement portion.

Abstract: A method for variably flexing and steering an insertion device that receives an instrument, which comprises providing a hollow body having tendons disposed therewithin and a distal end, changing a condition of the hollow body by selectively applying suction to create a vacuum in the hollow body to place the hollow body in a relatively stiff condition and relieving the vacuum to place the hollow body in a relatively flexible condition, maintaining the hollow body in the relatively flexible and relatively stiff conditions with the tendons, the vacuum created by the applied suction frictionally locking the tendons in place in the relatively stiff condition, and individually adjusting at least one of the tendons in length to steer the distal end of the hollow body.

Abstract: The illumination system comprises an arthroscope, endoscope or other suitable surgical tool and an attachable cannula comprising a transparent or semi-transparent material capable of carrying light from the proximal end of the cannula to the distal end of the cannula, thereby illuminating the surgical field. The surgical field is thus illuminated through components that do not occupy space that may otherwise by used for the optics of the arthroscope. The arthroscopic illumination system further comprises one or more illumination sources disposed at the proximal end of the cannula. The illumination source may be optically coupled with the cannula at the hub or other appropriate location. The cannula comprises a sterilizable polymer which functions as a waveguide. A waveguide is a material medium that confines and guides light. When in use, the light source connected to the hub provides light which may be guided to the distal end of the cannula or any other suitable location.

Abstract: A device for applying an attachment to an endoscope is disclosed. The device comprises an applicator supporting the attachment, an end of the attachment being accessible such that the endoscope is insertable into the attachment in a longitudinal direction. The attachment is removably secured to the applicator to enable the attachment to be withdrawn from the applicator together with the endoscope.

Abstract: Provided is a medical instrument which has improved operability of an insertion portion and can guide a distal end of the insertion portion to an intended position. The medical instrument includes: an insertion portion (10) which is inserted into a body cavity; a rotor (11) which is provided in an outer circumferential surface of the insertion portion (10) and has its rotational axis arranged in a direction along an axis of the insertion portion (10); and a rotary drive unit which rotates the rotor (11) around the rotational axis.

Abstract: A nasal cannula allows insertion of an upper endoscopy probe, a transesophageal echo probe for exams, or the like. Currently, a nasal cannula is used to measure expired carbon dioxide and deliver oxygen to sedated patients undergoing these procedures. Use of a face mask, such as a non-rebreathing face mask, during these procedures allows increased delivery of oxygen in patients with compromised respiratory function. A side port can be cut into the non-rebreathing face mask to allow insertion of the probes into patient's mouths while allowing delivery of a higher oxygen concentration. The facemask has the ability to easily separate from the nasal cannula, providing for continued use of the nasal cannula during, for example, a recovery period from sedation.

Abstract: A track-forming device can form an insertion route (track) along which a treatment tool is easily inserted. The track-forming device includes: a plurality of track-forming segmented members that are arranged in the longitudinal direction with spaces therebetween; a soft wire that connects the plurality of track-forming segmented members; and a wire pulling section that brings the plurality of track-forming segmented members into contact with each other in the longitudinal direction. When the plurality of track-forming segmented members are brought into contact with each other by the wire pulling section, a predetermined track is formed.

Abstract: An assist assembly for propulsion of a tip device of an endoscope in a body cavity includes an attachment sleeve and a support sleeve. A deformable circulation device is disposed to extend over inner and outer surfaces of the support sleeve, for endlessly moving in an axial direction of the tip device. Plural rollers are disposed on the support sleeve in a rotatable manner, for pressing an inner surface of the circulation device. An alignment projection is formed on the inner surface of the circulation device to project at a height L1. A location offset prevention groove is formed in the rollers at a depth L2, for receiving the alignment projection, and satisfying a condition L1?L2, to prevent location offset of the circulation device from the rollers. Drive wheels tension the circulation device in cooperation with the rollers by deforming the alignment projection in the location offset prevention groove.

Abstract: An endoscope sheath is provided for advancing medical devices into the anatomy of a patient. The endoscope sheath includes at least one lumen that may be used to advance devices alongside an endoscope. The endoscope sheath may include an endoscope cap configured to mate with the lumen. The endoscope may include one or more coupling members configured to mate with the openings of the lumen.

Abstract: Systems and methods employing a small gauge steerable catheter (30) including a locatable guide (32) with a sheath (40), particularly as an enhancement to a bronchoscope (14). A typical procedure is as follows. The location of a target in a reference coordinate system is detected or imported. The catheter (30) is navigated to the target which tracking the distal tip (34) of the guide (32) in the reference coordinate system. Insertion of the catheter is typically via a working channel of a convention bronchoscope. Once the tip of the catheter is positioned at the target, the guide (32) is withdrawn, leaving the sheath (40) secured in place. The sheath (40) is then used as a guide channel to direct a medical tool to target.

Abstract: The present invention discloses an endoscope positioning system for maneuvering, orienting and positioning an endoscope relative to an organ within a patient's body during an endoscopic operation. The endoscope positioning system comprises a gripper that reversibly attaches the positioning system to the patient's body while allowing full adjustment of the endoscope in four degrees of freedom.

Abstract: A system is provided for advancing medical devices along an endoscope to a selected target anatomy in a patient. The advancing system includes a tether having a first portion disposed through a working channel of an endoscope and a second portion disposed external the endoscope. The advancing system may include a guiding device configured to advance a medical device beyond a distal portion of the endoscope to a selected target anatomy.

Abstract: A minimal invasive neurosurgery assembly including a flush assembly having flush assembly main part with a central passage extending through the main part from the distal end to the proximal end along a longitudinal axis, and having at least one tool insertion assembly. The tool insertion assembly may include a tool handling part that is detachably connectable to the flush assembly main part and that has at least one tool insertion channel that extends from the distal end to the proximal end of the tool handling part. The tool insertion assembly may also include an inner sheath that is connected to the tool handling part and has an inner sheath wall and at least one lumen extending parallel to the longitudinal axis and in which an associated one of the at least one tool insertion channel emanates. The inner sheath may be insertable through the central passage of the flush assembly main part.

Abstract: A guide sheath includes: an elongated member extending along a longitudinal axis; a manipulation wire extending along the longitudinal axis of the elongated member so as to be capable of advancing and retracting; a bent section formed of a thermoplastic resin in a tubular shape and configured to be bent in accordance with advance or retraction of the manipulation wire; and a first hard section provided at a distal end surface of the bent section and formed by cross-linking the thermoplastic resin to which a distal end section of the manipulation wire is fixed.

Abstract: An insertion opening attachment is used in combination with an endoscope apparatus configured to observe the inside of a subject. The attachment is attached to an insertion opening opened in the subject into which an insertion unit of the endoscope apparatus is inserted, wherein the insertion opening attachment comprises an attachment main body having a flanged cylindrical shape which is fixed to a peripheral edge region of the insertion opening in a state the insertion opening attachment is inserted in the insertion opening. The attachment main body comprises is attachment state detection unit which detects whether the attachment main body is attached to the insertion opening and an insertion state detection unit which detects whether the insertion unit is inserted in the insertion opening.

Abstract: An endoscope system includes an endoscope, having a tip device for entry in a body cavity, and a viewing window portion formed in the tip device. A sleeve-shaped condition checking device is disposed on a distal side in an axial direction, for resiliently deforming in a transverse direction crosswise to the axial direction when pushed on an inner wall of the body cavity, to enter a viewing area of the viewing window portion. Furthermore, a propulsion assembly constitutes the condition checking device, and exerts force of propulsion to the tip device, for assistance to entry in the body cavity. The condition checking device includes a resilient end ring, disposed distally of a support sleeve, covered by a propulsion assembly, and having a tapered wall of which a diameter decreases in the axial direction from the support sleeve.

Abstract: An endoscopic support device configured to support an endoscope during a surgical procedure is disclosed. The endoscopic support device has a connection ring with a height smaller than its diameter and configured to be in an open or deployed position and in a closed or non-deployed position. The support device also has at least two guiding elements, an orientation component, and extension means for manipulating the ring between the deployed and non-deployed positions.

Abstract: An apparatus for accessing a bodily passageway includes: an endoscope including an insertion portion configured to inserted into the bodily passageway; a drive tube including a lumen configured to receive the endoscope; a helically-wound thread disposed on an outer wall of the drive tube and configured such that rotation of the drive tube causes the drive tube with the endoscope to move along the passageway; a flexible drive shaft configured to transfer rotary motion generated by a power supply; and a rotatable drive collar disposed on the endoscope and configured to rotate the drive tube relative to the endoscope, the rotatable drive collar including a stator, a rotor rotatable over the stator and detachably coupled to the drive tube, a rotary gear configured to transfer the rotary motion from the flexible drive shaft to the rotor to rotate the drive tube, and a watertight seal disposed between the stator and the rotor.

Abstract: An endoscopic device for autonomous locomotion through a selected body cavity in a predetermined direction, the device comprising a hollowed, cylindrical body that extends between two, preferably, the front and rear, end portions, respectively. The body is made of a relatively elastic material and includes an anchor for temporarily and alternately attaching the end portions to a wall portion of the body cavity in synch with corresponding axial extensions and contractions of the body. The body incorporates a reinforcement structure distributed along its length that is substantially rigid in a radial direction and yields in an axial direction, the structure specifically comprising either a plurality of relatively rigid rings or at least one helical spring.

Abstract: A slotted cannula for endoscopic surgical procedures is disclosed. The slotted cannula has a tubular body having a distal end, a proximate end, an open slot extending longitudinally from the beginning of the proximate end to the proximity of the distal end, and a pair of wings integrally formed on the proximate end. The tubular body is made from a transparent material and has an inner diameter large enough to accommodate an endoscope.

Abstract: An instrument for confirming the position of an indwelling gastrostomy catheter, and a method of confirming the indwelling position thereof, with which it is possible to reduce cleaning costs, and which does not cause any discomfort to a patient. An instrument for confirming the indwelling position of a gastrostomy catheter which is indwelling in a hole formed between the surface of the skin of the patient and the inner surface of the stomach wall comprising a fiberscope and a protective cover. Furthermore, the tip end of the protective cover comprises a light-transmissive window part and a wire that is linked to the outer periphery at the tip end of the protective cover.

Abstract: A shared bite block is disclosed which can be employed to simultaneously establish a viable airway for a patient, while providing surgical access to the esophagus of the patient. Structurally, the device includes a hollow, tubular shaped body portion that is formed as a sidewall with open ends. The sidewall surrounds an interior space and a partition extends across the interior space to divide the space and establish a hole and a guideway. A pair of extensions is each attached to the proximal end of the body portion and a flange is formed at the distal end of the body portion. In use, the patient bites down on the body portion between the extensions and the flange. An airway tube can then be inserted into the guideway of the body portion. Unobstructed surgical access into the esophagus is established through the hole of the body portion of the device.

Abstract: A remotely controlled insertion system for a medical device is described. The system comprises a robotic device and a remote control mechanism. The robotic device has a handle controller to receive and hold the control handle or proximal end of a medical device. The medical device is capable of moving in up to six ranges of motion. In one embodiment a first motor is connected through a drive screw to a handle controller to move the medical device forward and backward. A second motor is connected to drive wheels effective to rotate the medical device clockwise and counter-clockwise. A third motor drives a series of gears that are connected to one or more control members on the medical device, this being effective to deflect a tip of the medical device so that movement of the third motor causes such deflection. A control unit is connected to all three motors.

Abstract: Propellable apparatus, assemblies and related methods including a self-enclosed member are disclosed. The self-enclosed member can include an inner surface at least partially defining an enclosed region, and an outer surface that turns outwardly to engage a cavity or lumen wall in addition to turning inward to at least partially encompass a central region defining a longitudinal path. The apparatus can include an internal drive mechanism engageable with the outer surface of the self-enclosed member to provide relative movement between the self-enclosed member and the cavity or lumen wall. A tapered member, positioned on the apparatus adjacent an end of the self-enclosed member, can provide a size transition between an outer surface portion of the self-enclosed member and an outer surface of a payload insertable within the central region. In some examples, one or more reinforcing members can be integrated within the self-enclosed member for increased durability and rotational use.

Abstract: Methods and apparatus provide continuous guidance of endoscopy during a live procedure. A data-set based on 3D image data is pre-computed including reference information representative of a predefined route through a body organ to a final destination. A plurality of live real endoscopic (RE) images are displayed as an operator maneuvers an endoscope within the body organ. A registration and tracking algorithm registers the data-set to one or more of the RE images and continuously maintains the registration as the endoscope is locally maneuvered. Additional information related to the final destination is then presented enabling the endoscope operator to decide on a final maneuver for the procedure. The reference information may include 3D organ surfaces, 3D routes through an organ system, or 3D regions of interest (ROIs), as well as a virtual endoscopic (VE) image generated from the precomputed data-set.

Abstract: An intubating attachment apparatus for use with endotracheal intubation devices comprising an elongated, generally cylindrical support module configured to accommodate a fiber optic intubation scope and at least one of an endotracheal tube or an endotracheal tube exchanger. The invention obviates the need for an attending medical professional to utilize more than one hand when advancing an endotracheal tube and/or endotracheal tube exchanger along with the fiber optic bundle of a bronchoscope into a patient.

Abstract: Embodiments of the invention are directed to minimally invasive surgical instruments and procedures using those instruments wherein the instruments include optical elements (e.g. a percutaneous optical channel (POC), a retaining plug and a stereoscopic imaging device (e.g. a stereoscopic camera) and a stereoscopic display device. The instruments be part of a system used to provide a surgeon with an indirect stereoscopic view of a surgical area undergoing a minimally invasive surgical procedure in a way that is perceived by the surgeon as being similar to that of an open surgery and providing a natural and intuitive environment to perform the surgery with a high degree of control.

Abstract: Embodiments of the invention are directed to minimally invasive surgical instruments and procedures using those instruments wherein the instruments include optical elements (e.g. a percutaneous optical channel (POC), a retaining plug and a stereoscopic imaging device (e.g. a stereoscopic camera) and a stereoscopic display device. The instruments be part of a system used to provide a surgeon with an indirect stereoscopic view of a surgical area undergoing a minimally invasive surgical procedure in a way that is perceived by the surgeon as being similar to that of an open surgery and providing a natural and intuitive environment to perform the surgery with a high degree of control.

Abstract: Preparing an endoscope insertion assembly for performing endoscopy by providing the endoscope insertion assembly including an endoscope insertion tube operative for passage through a body cavity, and an optical assembly operative for inspection of said body cavity, and selectably inserting the optical assembly within said endoscope insertion tube.

Abstract: An insertion device includes a channel defining portion extended through an inside of an insertion section up to a base portion toward a distal direction and defining a channel that is open to an outside of the insertion section in an opening of an outer peripheral portion of the base portion, and a driving unit extended through an inside of the channel with a driving axis being an axial center and being rotatable in directions around the driving axis when driven. The insertion device includes a driving force receiving portion connected to a gear portion in the opening of the channel, and a support unit supporting the driving unit so that the driving axis is parallel to the longitudinal axis in the gear portion.

Abstract: A medical robotic system includes an entry guide with articulatable instruments extending out of its distal end, an entry guide manipulator providing controllable four degrees-of-freedom movement of the entry guide, and a controller configured to limit joint velocities in the entry guide manipulator so as to prevent movement of tips of the articulatable instruments from exceeding a maximum allowable linear velocity when the entry guide manipulator is being used to move the entry guide.

Abstract: An endoscope cleaning sheath includes a flexible tube body that is mounted to an insertion portion having a bending portion included in an endoscope, and that has a plurality of through-holes parallel to a longitudinal axis; and a cylindrical distal end nozzle that is provided at a distal end portion of the flexible tube body and that sprays at least one of a gas and a liquid at least at an observation window provided at a distal end portion of the insertion portion of the endoscope. The through-holes are a hole for an endoscope insertion portion through which the insertion portion of the endoscope is inserted, and at least a first fluid conduit that supplies gas and a second fluid conduit that supplies liquid. The first fluid conduit and the second fluid conduit are provided at positions in a direction that is different from a bending direction of the bending portion of the insertion portion that is inserted and disposed in the hole for an endoscope insertion portion.

Abstract: An endoscopic device capable of autonomous locomotion through a body cavity in a pre-established direction of displacement is described. The endoscopic device comprises a tubular body that extends between a front end portion and a rear end portion and a reinforcement structure distributed along the length of the tubular body. Each end portion includes an anchoring means for temporarily and alternately attaching the end portions to a wall of the body cavity.

Abstract: An endoscope support device is provided. The device includes a sleeve extending along a longitudinal axis between a first end and a second end. The sleeve includes an inner surface defining a passageway configured for disposal of an endoscope. An end surface of the distal end is spaced from external surroundings by a wall that defines the end surface. A center piece is disposed within the passageway. The center piece includes a first end that engages the end wall and an inner surface defining a lumen configured for disposal of an optical probe. The center piece is positioned within the passageway such that the lumen of the center piece is aligned with a lumen of the endoscope and the probe extends through the lumens. Systems, kits and methods are also provided.