Patent Publication Number: US-2023157531-A1

Title: Integrated container and tube set for fluid delivery with an endoscope

Description:
RELATED APPLICATIONS 
     This application is a continuation of and claims the benefit of the earlier filing date of U.S. patent application Ser. No. 17/558,239, filed on Dec. 21, 2021, which claims the benefit of priority under 35 U.S.C. § 119 to U.S. Provisional Patent Application No. 63/129,204, titled “Integrated Container and Tube Set for Fluid Delivery with an Endoscope”, filed on Dec. 22, 2020, and claims the benefit of priority under 35 U.S.C. § 119 to U.S. Provisional Patent Application No. 63/129,199, titled “Tubing Assemblies and Methods for Fluid Delivery”, filed on Dec. 22, 2020, each of which is incorporated herein by reference in its entirety. 
    
    
     FIELD 
     This disclosure relates generally to medical fluid containers and tubing assemblies and methods for fluid delivery, and particularly to an integrated bottle (e.g., container, reservoir, or the like) and tube assembly to supply fluid and/or gas to an endoscope. 
     BACKGROUND 
     Conventionally, endoscope devices have been widely used for performing diagnostic and/or therapeutic treatments. Such endoscope devices sometimes include a fluid capability, or the like, configured to feed fluid to the end of the endoscope for insufflating the inside of the patient at the target site. Lens wash provides a liquid such as sterilized water at relatively high pressure to spray across and clear the camera lens of debris. The water source for lens wash and irrigation typically has included one or more fluid reservoirs with tubing and cap assemblies that creates the plumbing circuit in connection with the endoscope channels and valving to accomplish the gas and water functions described. Such tubing and cap assemblies are available in various configurations, which typically involve a water bottle, a cap fitted for the specific bottle, and an array of tubing that is extendable through openings in the cap. The tubing typically is arranged to accommodate a specific configuration of endoscope fittings and valving. 
     It is with these considerations in mind that the improvements of the present disclosure may be useful. 
     SUMMARY 
     This summary of the disclosure is given to aid understanding, and one of skill in the art will understand that each of the various aspects and features of the disclosure may advantageously be used separately in some instances, or in combination with other aspects and features of the disclosure in other instances. No limitation as to the scope of the claimed subject matter is intended by either the inclusion or non-inclusion of elements, components, or the like in this summary. Accordingly, while the disclosure is presented in terms of aspects or embodiments, it should be appreciated that individual aspects can be claimed separately or in combination with aspects and features of that embodiment or any other embodiment. 
     According to an aspect, an integrated container and tube set arranged and configured to couple to an endoscope for use in an endoscopic procedure is disclosed. In one embodiment, the integrated container and tube set comprises a container configured to contain a fluid, the container having a bottom portion and a top portion, and a plurality of tubes integrally formed with the container. The plurality of tubes include an irrigation supply tube, a lens wash supply tube, and a gas supply tube. The irrigation supply tube includes a wall that is continuous with the container, the irrigation supply tube including a first end, a second end, and a first lumen extending therethrough, wherein the first end of the irrigation supply tube is in fluid communication with the bottom portion of the container and the second end of the irrigation supply tube is positioned external to the container. The lens wash supply tube includes a wall that is continuous with the container, the lens wash supply tube including a first end, a second end, a second lumen extending therethrough, wherein the first end of the lens wash supply tube is in fluid communication with the bottom portion of the container and the second end of the lens wash supply tube is positioned external to the container. The gas supply tube includes a wall that is continuous with the container, the gas supply tube including a first end, a second end, a third lumen extending therethrough, wherein the first end of the gas supply tube is in operative communication with the top portion of the container and the second end of the gas supply tube is positioned external to the container. 
     In various of the described and other embodiments within the scope of the present disclosure, the lens wash supply tube and the gas supply tube are arranged and configured as a multi-lumen tube. 
     In various of the described and other embodiments within the scope of the present disclosure, the second lumen is coaxial with the third lumen, with the second lumen positioned within the third lumen. 
     In various of the described and other embodiments within the scope of the present disclosure, the multi-lumen tube further comprises an internal wall extending along a length thereof between the second lumen and the third lumen so that the third lumen extends adjacent to the second lumen. 
     In various of the described and other embodiments within the scope of the present disclosure, each of the second ends of the irrigation supply tube, the lens wash supply tube, and the gas supply tube are sealed. 
     In various of the described and other embodiments within the scope of the present disclosure, each of the second ends of the irrigation supply tube, the lens wash supply tube, and the gas supply tube are arranged and configured with a one-way valve. 
     In various of the described and other embodiments within the scope of the present disclosure, at least one of the irrigation supply tube, the lens wash supply tube, and the gas supply tube, includes an adjustable connector coupled thereto, the adjustable connector moveable between a closed position and an opened position. 
     In various of the described and other embodiments within the scope of the present disclosure, the integrated container and tube set further comprises an endoscope adapter operatively coupled to the lens wash supply tube and the gas supply tube, the endoscope adapter comprising a fluid lumen in fluid communication with the second lumen and a gas lumen in communication with the third lumen, the endoscope adapter configured to interface with an endoscope. 
     In various of the described and other embodiments within the scope of the present disclosure, the integrated container and tube set further comprises an alternative gas supply tube having a wall that is continuous with the container, the alternative gas supply tube including a first end, a second end, and a fourth lumen extending therethrough, wherein the first end of the alternative gas supply tube is in operative communication with the top portion of the container and the second end of the alternative gas supply tube is positioned external to the container. 
     In various of the described and other embodiments within the scope of the present disclosure, a stop cock valve is coupled to the second end of the alternative gas supply tube. 
     In various of the described and other embodiments within the scope of the present disclosure, a pump is in fluid communication with the irrigation supply tube. 
     In various of the described and other embodiments within the scope of the present disclosure, the irrigation supply tube is configured to fluidly couple the first lumen with an irrigation channel of an endoscope. 
     In various of the described and other embodiments within the scope of the present disclosure, the container further comprises a supply port formed therein to couple with a fluid supply. 
     In various of the described and other embodiments within the scope of the present disclosure, the container is overmolded to each of the plurality of tubes. 
     In various of the described and other embodiments within the scope of the present disclosure, the container further comprises a fluid therein, wherein the fluid is a sterile fluid, the container sealing the sterile fluid from the atmosphere. 
     According to another aspect, an integrated container and tube set arranged and configured to couple to an endoscope for use during an endoscopic procedure is disclosed. The integrated container and tube set comprises a container configured to contain a fluid, an irrigation supply tube, a lens wash supply tube, and a gas supply tube. The container includes a bottom portion and a top portion. The irrigation supply tube includes a first end, a second end, and a first lumen extending therethrough, wherein the first end of the irrigation supply tube is reversibly coupled to the container, the first end of the irrigation supply tube being arranged and configured to be in fluid communication with the bottom portion of the container, and the second end of the irrigation supply tube is positioned external to the container. The lens wash supply tube includes a first end, a second end, and a second lumen extending therethrough, wherein the first end of the lens wash supply tube is reversibly coupled to the container, the first end of the lens wash supply tube being arranged and configured to be in fluid communication with the bottom portion of the container and the second end of the lens wash supply tube is positioned external to the container. The gas supply tube includes a first end, a second end, and a third lumen extending therethrough, wherein the first end of the gas supply tube is reversibly coupled to the container, the first end of the gas supply tube being arranged and configured to be in operative communication with the top portion of the container and the second end of the gas supply tube is positioned external to the container. 
     In various of the described and other embodiments within the scope of the present disclosure, the integrated container and tube set further comprises an alternative gas supply tube having a first end, a second end, and a fourth lumen extending therethrough, wherein the first end of the alternative gas supply tube is reversibly coupled to the container, the first end of the alternative gas supply tube being arranged and configured to be in operative communication with the top portion of the container and the second end of the alternative gas supply tube is positioned external to the container. 
     In various of the described and other embodiments within the scope of the present disclosure, the integrated container and tube set further comprises a penetrating member disposed on the first end of each of the irrigation supply tube, the lens wash supply tube, and the gas supply tube. 
     In various of the described and other embodiments within the scope of the present disclosure, the irrigation supply tube, the lens wash supply tube, and the gas supply tube are arranged and configured as a multi-lumen tube including the first lumen, the second lumen, and the third lumen. 
     According to another aspect, an integrated container and tube set arranged and configured to couple to an endoscope for use during an endoscopic procedure is disclosed. The integrated container and tube set comprises a container configured to contain a fluid, an irrigation supply tube, a lens wash supply tube, and a gas supply tube. The container includes a bottom portion and a top portion. The irrigation supply tube includes a wall that is continuous with the container, the irrigation supply tube including a first end, a second end, and a first lumen extending through the first end and along a length of the irrigation supply tube toward the second end of the irrigation supply tube, wherein the first end of the irrigation supply tube is in fluid communication with the bottom portion of the container and the second end of the irrigation supply tube is closed to the first lumen. The lens wash supply tube includes a wall that is continuous with the container, the lens wash supply tube including a first end, a second end, a second lumen extending through the first end of the lens wash supply tube and along a length of the lens wash supply tube toward the second end of the lens wash supply tube, wherein the first end of the lens wash supply tube is in fluid communication with the bottom portion of the container and the second end of the lens wash supply tube is closed to the second lumen. The gas supply tube includes a wall that is continuous with the container, the gas supply tube including a first end, a second end, a third lumen extending through the first end of the gas supply tube and along a length of the gas supply tube toward the second end of the gas supply tube, wherein the first end of the gas supply tube is in operative communication with the top portion of the container and the second end of the gas supply tube is closed to the third lumen. 
     In various of the described and other embodiments within the scope of the present disclosure, the integrated container and tube set further comprises an alternative gas supply tube having a wall that is continuous with the container, the alternative gas supply tube including a first end, a second end, and a fourth lumen extending through the first end of the alternative gas supply tube and along a length of the alternative gas supply tube toward the second end of the alternative gas supply tube, wherein the first end of the alternative gas supply tube is in operative communication with the top portion of the container and the second end of the alternative gas supply tube is closed to the fourth lumen. 
     In various of the described and other embodiments within the scope of the present disclosure, each second end of each of the irrigation supply tube, the lens wash supply tube, and the gas supply tube are configured to be penetrated by an adapter member. 
     According to another aspect, an integrated container and tube set arranged and configured to couple to an endoscope for use during an endoscopic procedure is disclosed. The integrated container and tube set comprise a container configured to contain a fluid, a coaxial tube, and an irrigation supply tube. The container includes an upper half and a lower half. The upper half includes a fill port. The coaxial tube is coupled to the upper half of the container and includes an inner tube and an outer tube. The inner tube includes a lens wash supply tube and terminates in the lower half of the container. The outer tube includes a gas supply tube and terminates in the upper half of the container. The irrigation supply tube is coupled to the lower half of the container and terminates in the lower half of the container. 
     In various of the described and other embodiments within the scope of the present disclosure, the outer tube is integrally formed with the container. 
     In various of the described and other embodiments within the scope of the present disclosure, the irrigation supply tube is integrally formed with the container. 
     In various of the described and other embodiments within the scope of the present disclosure, the integrated container and tube set further comprise an alternative gas supply tube coupled to the upper half of the container. In many embodiments, the alternative gas supply tube terminates in the upper half of the container. In some embodiments, the alternative gas supply tube is integrally formed with the container 
     In various of the described and other embodiments within the scope of the present disclosure, the container includes an interface configured to couple the container to a mount or holder. In some embodiments, the interface includes a hook or loop in the upper half of the container. 
     In various of the described and other embodiments within the scope of the present disclosure, the integrated container and tube set further comprise a gas/lens wash connection attached to an end of the coaxial tube and configured to interface with an endoscope. In some embodiments, the gas/lens wash connection includes a coaxial split connector comprising first and second openings. The first opening may be in fluid communication with the inner tube and the second opening may be in fluid communication with the outer tube. 
     In various of the described and other embodiments within the scope of the present disclosure, the gas supply tube may include a check valve configured to only allow flow from the gas supply tube into the container. In many embodiments, the coaxial tube may be coupled to the upper half of the container via a coaxial split connector. In many such embodiments, a gas supply port of the coaxial split connector may include a check valve coupled thereto. 
     In some embodiments, a check valve may be disposed between the gas supply tubing and an interior of the container. In some such embodiments, the check valve is configured only allow flow from the gas supply tubing into the container. In one embodiment, the check valve may include an umbrella style check valve that extends between the inner and out tubes of the coaxial tube to create a one-way seal between the lens wash tubing and the gas supply tube. 
     In various of the described and other embodiments within the scope of the present disclosure, the container may include a first chamber and a second chamber connected by a side channel. In some such embodiments, the side channel may include a check valve that only allows flow from the second chamber to the first chamber. In various such embodiments, the coaxial tube is coupled to the first chamber. In many embodiments, the side channel may be integrally formed with the container. In some embodiments, the container may be collapsible. 
     These and other features and advantages of the present disclosure will be readily apparent from the following detailed description, the scope of the claimed invention being set out in the appended claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate various exemplary embodiments and together with the description serve to explain the principles of the present disclosure. 
         FIG.  1    depicts components of an endoscope; 
         FIG.  2    depicts components of an endoscope system with endoscope, light source, light source connector, water reservoir, and tubing assembly for air and lens wash fluid delivery; 
         FIG.  3 A  depicts an endoscope system with endoscope, light source, water reservoir, and tubing assembly for hybrid air, lens wash and irrigation fluid delivery, wherein the system is activated to deliver air to atmosphere; 
         FIG.  3 B  depicts the endoscope system of  FIG.  3 A , wherein the system is activated to deliver air to a patient through the patient end of the endoscope; 
         FIG.  3 C  depicts the endoscope system of  FIG.  3 A , wherein the system is activated to deliver lens wash fluid through the patient end of the endoscope; 
         FIG.  3 D  depicts the endoscope system of  FIG.  3 A , wherein the system is activated to deliver irrigation fluid through the patient end of the endoscope; 
         FIG.  4    depicts an endoscope system with endoscope, light source, water reservoir, and tubing assembly for hybrid air/lens wash, irrigation, and gas fluid delivery; 
         FIG.  5    depicts an integrated container and tube set or assembly suitable for use with an endoscope system, according to an embodiment of the present disclosure; 
         FIG.  6    depicts a detailed view of a second end of the tubes of the integrated container and tube set of  FIG.  5   , wherein one or more of the tubes include a one-way valve and/or an adaptor (e.g., a coaxial split connector, a stop-cock adaptor), according to an embodiment of the present disclosure; 
         FIG.  7    depicts a cross-sectional view of the integrated container and tube set of  FIG.  5   , wherein the first and second tubes are in fluid communication with a bottom portion of the container and the third and fourth tubes are in communication with a top portion of the container, according to an embodiment of the present disclosure; 
         FIG.  8 A  depicts an alternate embodiment of an integrated container and tube set suitable for use with an endoscope system, wherein the container is a non-rigid container, according to an embodiment of the present disclosure; 
         FIG.  8 B  depicts an exploded view of the integrated container and tube set of  FIG.  8 A , wherein the tubes include a sharpened end portion for piercing the non-rigid container, according to an embodiment of the present disclosure; 
         FIG.  9    depicts an alternate embodiment of an integrated container and tube set suitable for use with an endoscope system, wherein the tubes include a seal formed in a second end thereof, according to an embodiment of the present disclosure; 
         FIG.  10 A  depicts a detailed view of the second end of the tubes of the integrated container and tube set of  FIG.  9   ; 
         FIG.  10 B  illustrates a detailed view of the second end of the tubes of the integrated container and tube set of  FIG.  9   , wherein the second end of one of the tubes includes a coaxial split connector as an adaptor and the second end of one of the tubes includes a stop-cock adaptor, according to an embodiment of the present disclosure; 
         FIG.  11 A  depicts an integrated container and tube set or assembly suitable for use with an endoscope system, according to an embodiment of the present disclosure; 
         FIG.  11 B  depicts an integrated container and tube set or assembly suitable for use with an endoscope system, according to an embodiment of the present disclosure; 
         FIG.  11 C  depicts an integrated container and tube set or assembly suitable for use with an endoscope system, according to an embodiment of the present disclosure; 
         FIG.  12    depicts a container in first and second states, according to an embodiment of the present disclosure; 
         FIG.  13    depicts a container with a neck portion, according to an embodiment of the present disclosure; 
         FIG.  14 A  depicts an integrated container and tube set or assembly comprising a check valve suitable for use with an endoscope system, according to an embodiment of the present disclosure; and 
         FIG.  14 B  depicts an integrated container and tube set or assembly comprising a two-chamber container suitable for use with an endoscope system, according to an embodiment of the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     This disclosure is now described with reference to an exemplary medical system that may be used in endoscopic medical procedures. However, it should be noted that reference to this particular procedure is provided only for convenience and not intended to limit the disclosure. A person of ordinary skill in the art would recognize that the concepts underlying the disclosed devices and related methods of use may be utilized in any suitable procedure, medical or otherwise. This disclosure may be understood with reference to the following description and the appended drawings, wherein like elements are referred to with the same reference numerals. 
     Wherever possible, the same or similar reference numbers will be used through the drawings to refer to the same or like parts. The term “distal” refers to a portion farthest away from a user when introducing a device into a patient. By contrast, the term “proximal” refers to a portion closest to the user when placing the device into the patient. As used herein, the terms “comprises,” “comprising,” or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not necessarily include only those elements, but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. The term “exemplary” is used in the sense of “example,” rather than “ideal.” Further, as used herein, the terms “about,” “approximately” and “substantially” indicate a range of values within +/−10% of a stated or implied value. Additionally, terms that indicate the geometric shape of a component/surface refer to exact and approximate shapes. 
     Although embodiments of the present disclosure are described with specific reference to a bottle (e.g., container, reservoir, or the like) and tube assembly or set, it should be appreciated that such embodiments may be used to supply fluid and/or gas to an endoscope, for a variety of different purposes, including, for example to facilitate insufflation of a patient, lens washing, and/or to irrigate a working channel to aid in flushing/suctioning debris during an endoscopic procedure. 
     Although the present disclosure includes description of a bottle and tube set suitable for use with an endoscope system to supply fluid and/or gas to an endoscope, the devices, systems, and methods herein could be implemented in other medical systems requiring fluid and/or gas delivery, and for various other purposes. 
     It is noted that references in the specification to “an embodiment”, “some embodiments”, “other embodiments”, etc., indicate that the embodiment(s) described may include a particular feature, structure, or characteristic, but every embodiment may not necessarily include the particular feature, structure, or characteristic. Moreover, such phrases are not necessarily referring to the same embodiment. Further, when a particular feature, structure, or characteristic is described in connection with an embodiment, it would be within the knowledge of one skilled in the art to affect such feature, structure, or characteristic in connection with other embodiments, whether or not explicitly described, unless clearly stated to the contrary. That is, the various individual elements described below, even if not explicitly shown in a particular combination, are nevertheless contemplated as being combinable or arrangeable with each other to form other additional embodiments or to complement and/or enrich the described embodiment(s), as would be understood by one of ordinary skill in the art. 
     With reference to  FIGS.  1 - 2   , an exemplary endoscope  100  and system  200  is depicted that may comprise an elongated shaft  100   a  that is inserted into a patient. A light source  205  feeds illumination light to a distal portion  100   b  of the endoscope  100 , which may house an imager (e.g., CCD or CMOS imager) (not shown). The light source  205  (e.g., lamp) is housed in a video processing unit  210  that processes signals that are input from the imager and outputs processed video signals to a video monitor (not shown) for viewing. The video processing unit  210  also serves as a component of an air/water feed circuit by housing a pressurizing pump  215 , such as an air feed pump, in the unit. 
     The endoscope shaft  100   a  may include a distal tip  100   c  provided at the distal portion  100   b  of the shaft  100   a  and a flexible bending portion  105  proximal to the distal tip  100   c.  The flexible bending portion  105  may include an articulation joint (not shown) to assist with steering the distal tip  100   c.  On an end face  100   d  of the distal tip of the endoscope  100  is a gas/lens wash nozzle  220  for supplying gas to insufflate the interior of the patient at the treatment area and for supplying water to wash a lens covering the imager. An irrigation opening  225  in the end face  100   d  supplies irrigation fluid to the treatment area of the patient. Illumination windows (not shown) that convey illumination light to the treatment area, and an opening  230  to a working channel  235  extending along the shaft  100   a  for passing tools to the treatment area, also may be included on the face  100   d  of the distal tip  100   c.  The working channel  235  extends along the shaft  100   a  to a proximal channel opening  110  positioned distal to an operating handle  115  of the endoscope  100 . A biopsy valve  120  may be utilized to seal the channel opening  110  against unwanted fluid egress. 
     The operating handle  115  may be provided with knobs  125  for providing remote 4-way steering of the distal tip via wires connected to the articulation joint in the bendable flexible portion  105  (e.g., one knob controls up-down steering and another knob control for left-right steering). A plurality of video switches  130  for remotely operating the video processing unit  210  may be arranged on a proximal end side of the handle  115 . In addition, the handle is provided with dual valve wells  135  that receive a gas/water valve  140  for operating an insufflating gas and lens water feed operation. A gas supply line  240   a  and a lens wash supply line  245   a  run distally from the gas/water valve  140  along the shaft  100   a  and converge at the distal tip  100   c  proximal to the gas/wash nozzle  220  ( FIG.  2   ). The other valve well  135  receives a suction valve  145  for operating a suction operation. A suction supply line  250   a  runs distally from the suction valve  145  along the shaft  100   a  to a junction point in fluid communication with the working channel  235  of the endoscope  100 . 
     The operating handle  115  is electrically and fluidly connected to the video processing unit  210 , via a flexible umbilical  260  and connector portion  265  extending therebetween. The flexible umbilical  260  has a gas (e.g., air or CO 2 ) feed line  240   b,  a lens wash feed line  245   b,  a suction feed line  250   b,  an irrigation feed line  255   b,  a light guide (not shown), and an electrical signal cable. The connector portion  265  when plugged into the video processing unit  210  connects the light source  205  in the video processing unit with the light guide. The light guide runs along the umbilical  260  and the length of the endoscope shaft  100   a  to transmit light to the distal tip  100   c  of the endoscope  100 . The connector portion  265  when plugged into the video processing unit  210  also connects the air pump  215  to the gas feed line  240   b  in the umbilical  260 . 
     A water reservoir  270  (e.g., water bottle) is fluidly connected to the endoscope  100  through the connector portion  265  and the umbilical  260 . A length of gas supply tubing  240   c  passes from one end positioned in an air gap  275  between the top  280  (e.g., bottle cap) of the reservoir  270  and the remaining water  285  in the reservoir to a detachable gas/lens wash connection  290  on the outside of the connector portion  265 . The gas feed line  240   b  from the umbilical  260  branches in the connector portion  265  to fluidly communicate with the gas supply tubing  240   c  at the detachable gas/lens wash connection  290 , as well as the air pump  215 . A length of lens wash tubing  245   c,  with one end positioned at the bottom of the reservoir  270 , passes through the top  280  of the reservoir to the same detachable connection  290  as the gas supply tubing  240   c  on the connector portion  265 . In other embodiments, the connections may be separate and/or separated from each other. The connector portion  265  also has a detachable irrigation connection  293  for irrigation supply tubing (not shown) running from a source of irrigation water (not shown) to the irrigation feed line  255   b  in the umbilical  260 . In some embodiments, irrigation water is supplied via a pump (e.g., peristaltic pump) from a water source independent (not shown) from the water reservoir  270 . In other embodiments, the irrigation supply tubing and lens wash tubing  245   c  may source water from the same reservoir. The connector portion  265  may also include a detachable suction connection  291  for suction feed line  250   b  and suction supply line  250   a  fluidly connecting a vacuum source (e.g., hospital house suction) (not shown) to the umbilical  260  and endoscope  100 . 
     The gas feed line  240   b  and lens wash feed line  245   b  are fluidly connected to the valve well  135  for the gas/water valve  140  and configured such that operation of the gas/water valve in the well controls supply of gas or lens wash to the distal tip  100   c  of the endoscope  100 . The suction feed line  250   b  is fluidly connected to the valve well  135  for the suction valve  145  and configured such that operation of the suction valve in the well controls suction applied to the working channel  235  of the endoscope  100 . 
     Referring to  FIG.  2   , an exemplary operation of an endoscopic system  200 , including an endoscope such as endoscope  100  above, is explained. Air from the air pump  215  in the video processing unit  210  is flowed through the connection portion  265  and branched to the gas/water valve  140  on the operating handle  115  through the gas feed line  240   b  in the umbilical  260 , as well as through the gas supply tubing  240   c  to the water reservoir  270  via the connection  290  on the connector portion  265 . When the gas/water valve  140  is in a neutral position, without the user&#39;s finger on the valve, air is allowed to flow out of the valve to atmosphere. In a first position, the user&#39;s finger is used to block the vent to atmosphere. Gas is allowed to flow from the valve  140  down the gas supply line  240   a  and out the distal tip  100   c  of the endoscope  100  in order to, for example, insufflate the treatment area of the patient. When the gas/water valve  140  is pressed downward to a second position, gas is blocked from exiting the valve, allowing pressure of the air passing from the air pump  215  to rise in the water reservoir  270 . Pressurizing the water source forces water out of the lens wash tubing  245   c,  through the connector portion  265 , umbilical  260 , through the gas/water valve  140  and down the lens wash supply line  245   a,  converging with the gas supply line  240   a  prior to exiting the distal tip  100   c  of the endoscope  100  via the gas/lens wash nozzle  220 . Air pump pressure may be calibrated to provide lens wash water at a relatively low flow rate compared to the supply of irrigation water. 
     The volume of the flow rate of the lens wash is governed by gas pressure in the water reservoir  270 . When gas pressure begins to drop in the water reservoir  270 , as water is pushed out of the reservoir  270  through the lens wash tubing  245   c,  the air pump  215  replaces lost air supply in the reservoir  270  to maintain a substantially constant pressure, which in turn provides for a substantially constant lens wash flow rate. In some embodiments, a filter (not shown) may be placed in the path of the gas supply tubing  240   c  to filter-out undesired contaminants or particulates from passing into the water reservoir  270 . In some embodiments, outflow check valves or other one-way valve configurations (not shown) may be placed in the path of the lens wash supply tubing to help prevent water from back-flowing into the reservoir  270  after the water has passed the valve. 
     A relatively higher flow rate compared to lens wash is typically required for irrigation water, since a primary use is to clear the treatment area in the patient of debris that obstructs the user&#39;s field of view. Irrigation is typically achieved with the use of a pump (e.g., peristaltic pump), as described. In embodiments with an independent water source for irrigation, tubing placed in the bottom of a water source is passed through the top of the water source and threaded through the head on the upstream side of the pump. Tubing on the downstream side of the pump  255   c  is connected to the irrigation feed line  255   b  in the umbilical  260  and the irrigation supply line  255   a  endoscope  100  via the irrigation connection  293  on the connector portion  265 . When irrigation water is required, fluid is pumped from the water source by operating the irrigation pump, such as by depressing a footswitch (not shown), and flows through the irrigation connection  293 , through the irrigation feed line  255   b  in the umbilical, and down the irrigation supply line in the shaft  100   a  of the endoscope to the distal tip  100   c.  In order to equalize the pressure in the water source as water is pumped out of the irrigation supply tubing, an air vent (not shown) may be included in the top  280  of the water reservoir  270 . The vent allows atmospheric air into the water source preventing negative pressure build-up in the water source, which could create a vacuum that suctions undesired matter from the patient back through the endoscope toward the water source. In some embodiments, outflow check valves or other one-way valve configurations (not shown), similar to the lens wash tubing  245   c,  may be placed in the path of the irrigation supply tubing to help prevent back-flow into the reservoir after water has passed the valve. 
       FIGS.  3 A- 3 D  are schematic drawings illustrating the operation of an embodiment of a hybrid system  300  where the supply tubing for irrigation and lens wash are connected to and drawn from a single water reservoir. The hybrid system  300  includes the single water reservoir  305 , a cap  310  for the reservoir, gas supply tubing  240   c,  lens wash supply tubing  245   c,  irrigation pump  315  with foot switch  318 , upstream irrigation tubing  320  and downstream irrigation supply tubing  255   c.  The cap  310  may be configured to attach in a seal-tight manner to the water reservoir  305  by a typically threaded arrangement. The cap may include a gasket to seal the cap  310  to the reservoir  305 . The gasket can be an O-ring, flange, collar, and/or the like and can be formed of any suitable material. A number of through-openings ( 325   a,    325   b,    325   c ) in the cap  310  are provided to receive, respectively, the gas supply tubing  240   c,  lens wash supply tubing  245   c,  and upstream irrigation supply tubing  320 . In  FIGS.  3 A- 3 D , the system depicted includes separate tubing for gas supply, lens wash and irrigation. 
     In other embodiments, the gas supply tubing  240   c  and lens wash tubing  245   c  may be combined in a coaxial arrangement, as will be described in more detail below, such as with respect to  FIGS.  11 A- 11 C, and  14 A- 14 B . For example, the gas supply tubing may define a lumen that is sufficiently large in diameter to encompass a smaller diameter lens wash tubing, coaxially received within the gas supply tubing, as well as provide air to the water source in an annular space surrounding the lens wash tubing to pressurize the water reservoir (see, e.g., gas and lens wash supply tubing  240   c,    245   c ). The lens wash supply tubing may be configured to exit the lumen defined by the coaxial gas supply tubing in any suitable sealed manner, such as, for example, an aperture, fitting, collar, and/or the like, for the purpose of transitioning from the coaxial arrangement to a side-by-side arrangement at the detachable gas/lens wash connection to the endoscope connector portion (e.g., connector portion  265  of  FIG.  2   ). 
     In various embodiments, different configurations of valving (not shown) may be incorporated into various embodiments disclosed hereby, including the tubing of the system  200 ,  300 . For example, an in-flow check valve can be disposed in the path of the gas supply tubing  240   c  to help prevent backflow into the air pump  215 . In this manner, pressure building within the water reservoir  270 ,  305  creates a pressure difference between the water source and the gas supply tubing  240   c  helping to maintain a positive pressure in the water source even when large amounts of water may be removed from the water source during the irrigation function. This arrangement compensates for any time lag in air being delivered from the air pump  215  to the water reservoir  270 ,  305 , which might otherwise cause a negative pressure vacuum in the water reservoir. Similarly, an out-flow check valve, such as the one-way valve with inlet/outlets and valve insert, may be incorporated in the lens wash supply tubing  240   c,  upstream irrigation supply tubing  320 , and/or downstream irrigation supply tubing  255   c  to help prevent backflow of water from either or both of the lens wash and irrigation tubing in the event of a negative pressure situation, as described. One or more of these techniques are described in more detail below, such as with respect to  FIGS.  14 A and  14 B . 
     More generally, in many embodiments, a check valve may refer to any type of configuration for fluid to flow only in one direction in a passive manner. For example, a check valve may include ,or refer to, one or more of a ball check valve, a diaphragm check valve, a swing check valve, a tilting disc check valve, a flapper valve, a stop-check valve, a lift-check valve, an in-line check valve, a duckbill valve, a pneumatic non-return valve, a reed valve, a flow check. Accordingly, a check valve as used herein is meant to be separate and distinct from an active valve that is operated in a binary manner as an on/off valve or switch to allowed flow to be turned on or allow flow to be turned off (e.g., a stop cock valve, solenoid valve, peristaltic pump). 
     During operation of the system of  FIGS.  3 A- 3 D , a flow of water for irrigation may be achieved by operating the irrigation pump  315 . A flow of water for lens wash may be achieved by depressing the gas/water valve  140  on the operating handle  115  of the endoscope  100 . These functions may be performed independent of one another or simultaneously. When operating lens wash and irrigation at the same time, as fluid is removed from the water reservoir  270 ,  305 , the pressure in the system may be controlled to maintain the lens wash supply tubing  240   c  at substantially the pressure necessary to accomplish a lower flow rate lens wash, while compensating for reduced pressure in the water reservoir  270 ,  305  due to supplying a high flow rate irrigation. When pressure is reduced in the water reservoir by use of the lens wash function, the irrigation function, or both functions simultaneously, the reduced pressure may be compensated for by the air pump  215  via the gas supply tubing  240   c.    
     The schematic set-up in  FIGS.  3 A- 3 D  has been highlighted to show the different flow paths possible with the hybrid system  300  having supply tubing for irrigation  320  and lens wash  240   c  connected to and drawn from the single water reservoir  305 . As shown in  FIG.  3 A , the endoscope  100  is in a neutral state with the gas/water valve  140  in an open position. The neutral state delivers neither gas, nor lens wash, to the distal tip of the endoscope. Rather gas (pressure) is delivered along path A from the pressurizing air pump  215  and vented through the gas feed line  240   b  in the umbilical  260  via the connector portion  265  and through the gas/water valve to atmosphere. Since the system is open at the vent hole in the gas/water valve  140 , there is no build up to pressurize the water reservoir  305  and consequently no water is pushed through the lens wash supply tubing  240   c.    
     As shown in  FIG.  3 B , the endoscope  100  is in a gas delivery state with the gas/water valve  140  in a first position. When gas is called for at the distal tip  100   c,  for example, to clean the end face  100   d  of the distal tip or insufflate the patient body in the treatment area, the user closes off the vent hole in the gas/water valve  140  with a thumb, finger, or the like (first position). In this state, gas (pressure) is delivered along path B from the air pump  215  and flowed through the gas feed line  240   b  in the umbilical  260  via the connector portion  265 . The gas continues through the gas/water valve  140  to the gas supply line  240   a  in the endoscope shaft  100   a  and out the gas/lens wash nozzle  220  at the distal tip  100   c.  There is no build up to pressurize the water reservoir since the system is open at the gas/lens water nozzle  220 , and consequently no water is pushed through the lens wash supply tubing  240   c.    
     As shown in  FIG.  3 C , the endoscope  100  is in a lens wash delivery state with the gas/water valve  140  in a second position. When lens wash is called for at the distal tip  100   c,  for example, to clean the end face  100   d  of the distal tip  100   c,  the user, keeping the vent hole in the air/water valve closed off, depresses the valve  140  to its furthest point in the valve well  135 . The second position blocks off the gas supply to both atmosphere and the gas supply line  240   a  in the endoscope, and opens up the gas/water valve  140  to allow lens wash water to pass through to the lens wash supply line  245   a  in the endoscope shaft  100   a  and out the gas/lens wash nozzle  220  at the distal tip  100   c.  In this state, gas (pressure) is delivered along path C from the air pump  215 , through the branched line in the connector portion  265  and out of the gas supply tubing  240   c  to the water reservoir  305 . The gas (pressure) pressurizes the surface of the remaining water  285  in the reservoir  305  and pushes water up the lens wash supply tube  245   c  to the connector portion  265 . The pressurized lens wash water is pushed further through the lens wash feed line  245   b  in the umbilical  260  and through the gas/water valve  140 . Since the system  300  is closed, gas pressure is allowed to build and maintain a calibrated pressure level in the water reservoir  305 , rather than venting to atmosphere or being delivered to the patient. This pressure, along with the endoscope feed and supply lines and external tubing, translates to a certain range of flow rate of the lens wash. 
     As shown in  FIG.  3 D , the endoscope  100  is in an irrigation delivery state. This may be performed at the same or a different time from the delivery of gas and/or lens wash. When irrigation is called for at the distal tip  100   c,  for example, if visibility in the treatment area is poor or blocked by debris, or the like, the user activates the irrigation pump  315  (e.g., by depressing foot switch  318 ) to delivery water along path D. With the pump  315  activated, water is sucked out of the water reservoir  305  through the upstream irrigation supply tubing  320  and pumped along the downstream irrigation supply tubing  255   c  to the connector portion  265 . The irrigation pump head pressure pushes the irrigation water further through the irrigation feed line  255   b  in the umbilical  260 , through the irrigation supply line  255   a  in the endoscope shaft  100   a,  and out the irrigation opening  225  at the distal tip  100   c.  The irrigation pump pressure may be calibrated, along with the endoscope irrigation feed and supply lines and external tubing, to deliver a certain range of flow rate of the irrigation fluid. 
       FIG.  4    is a schematic drawing illustrating a further embodiment of a hybrid system  400  including a video processing unit  210 , connector portion  265 , peristaltic irrigation pump  315 , water reservoir  405  and top  407 , coaxial gas and lens wash supply tubing  410 , upstream and downstream irrigation supply tubing  320 ,  255   c,  and alternative gas supply tubing  415  (e.g., CO 2 ). A length of the alternative gas supply tubing  415  passes from one end positioned in the gas gap  275  between the top  407  of the water reservoir  405  and the remaining water  285  in the reservoir through an additional opening  420  in the top of the reservoir to a detachable connection  425  for a source of the alternative gas supply (e.g., CO 2  hospital house gas source). When the alternative gas supply is desired, such as CO 2  gas, the air pump  215  on the video processing unit  210  may be turned off and CO 2  gas, rather than air, is thereby flowed to the water reservoir  405  pressurizing the water surface. In the neutral state, CO 2  gas flows backward up the gas supply tubing  240   c  to the connector portion  265 , up the gas feed line  240   b,  and is vented through the gas/water valve  140  to atmosphere. In the first position, the user closes off the vent hole in the gas/water valve  140 , and the CO 2  gas is flowed through the gas/water valve to the gas supply line  240   a  in the endoscope shaft  100   a  and out the gas/lens wash nozzle  220  at the distal tip  100   c.  In the second position, the user depresses the valve  140  to the bottom of the valve well  135 , keeping the vent hole in the gas/water valve closed off. The second position blocks the CO 2  gas supply to both atmosphere and the gas supply line  240   a  in the endoscope  100 , and opens up the gas/water valve  140  to allow lens wash water to pass through to the lens wash supply line  245   a  in the endoscope shaft  100   a  and out the gas/lens wash nozzle  220  at the distal tip  100   c.  Gas (pressure) in the reservoir  405  is maintained by delivery gas through alternative gas (e.g., CO 2 ) supply tubing  415 . The irrigation function may be accomplished in a similar manner as the operation described above with respect to  FIG.  3 D . 
     Referring to  FIGS.  5 - 11 C and  14 - 15    in accordance with principles of the present disclosure, in one embodiment, the water reservoir, bottle, container, etc. (such terms being used interchangeably without intent to limit or otherwise convey different meaning or intent) and the tubing assembly or tube sets (such terms being used interchangeably without intent to limit or otherwise convey different meaning or intent) may be integrally formed so that the water container and one or more tubes are permanently and non-separably coupled to each other (e.g., tubes are incapable of being disconnected from the container (e.g., cap of existing devices is eliminated). Collectively referred to herein as an integrated container and tube set. It will be appreciated that one or more tubes of an integrated container and tube set may be removably coupled to the container without departing from the scope of this disclosure. 
     In embodiments formed in accordance with principles of the present disclosure, container and tube sets are combined into an integrated container and tube set in which one or more of the tubes are combined or merged with the container, which is filled with a fluid such as, H 2 O, and air such as, for example, air, CO 2 , etc. For example, in one embodiment, the container and the tubes may be simultaneously formed or molded. Alternatively, in one embodiment, the tubes may be initially formed or molded and the container may be formed or molded around, to, or the like, the tubes. The integrated container and tube set may then be filled with water and sealed to create a sterilized container for use in an endoscopic procedure. Thus arranged, an improved fluid and gas container is provided that decreases the likelihood of infection. In addition, the integrated container and tube set provides manufacturers with increased flexibility and fewer component parts. In one embodiment, the integrated container and tube set can be configured as a single use item (e.g., a disposable single use item that is intended to be discarded after use), although, in one embodiment, the integrated container and tube set can be refillable and thus reusable. In one embodiment, the integrated container and tube set may be provided in an off-the-shelf sterile container to supply fluid and/or gases to an endoscope during an endoscopic procedure. 
     In one embodiment, the integrated container and tube set may replace (e.g., take the place of) the water reservoir and cap of the system described above in connection with  FIGS.  1 - 4   . That is, during use, the integrated container and tube set may be used in conjunction with (e.g., coupled to) an endoscope to supply fluid and/or gases to the endoscope in order to, for example, irrigate, lens wash, and insufflate during the endoscopic procedure. To this end, in one embodiment, the integrated water reservoir and tube set includes a plurality of tubes (e.g., lumens) for suppling fluid (e.g., water) and/or gas (e.g., CO 2 , air, etc.) to an endoscope to accommodate various endoscopic procedures as previously described. For example, in one embodiment, the integrated container and tube set may include a first irrigation supply tube, a second lens wash supply tube, and a third gas supply tube. In addition, the integrated container and tube set may include a fourth alternate gas supply tube. Thus arranged, as previously described above in connection with  FIGS.  1 - 4   , depending on actuation of the endoscope system, the integrated container and tube set may be arranged and configured to (i) supply gas (e.g., air or CO 2 ) to insufflate the patient, (ii) supply fluid to flush or clean the lens of the endoscope, and (iii) supply fluid for irrigation (e.g., flushing and/or suctioning of the working channel). During use, as previously described above in connection with  FIGS.  1 - 4   , depending on the user&#39;s manipulation of the valves on the endoscopes and other corresponding foot pedals and connectors, delivery of either fluid or gas to the endoscope in a desired manner is provided (e.g., supplying high pressure/volume fluid for irrigation, fluid for lens wash, or air/gas for patient insufflation. 
     In many embodiments formed in accordance with principles of the present disclosure, aspects of the present disclosure may result in more efficient and/or environmentally friendly endoscopic systems. In several embodiments, the integrated container and tube sets may reduce waste, such as by facilitating reusability. For example, fill ports may be included to replenish a supply of liquid in the containers. The fill ports may additionally enable the use of different fluids, such as to support a multitude of endoscopic procedures. In some embodiments, the integrated container and tube sets may decrease associated logistical and storage costs. For example, the integrated container may be collapsible to reduce volume needed to store or package the integrated container and tube sets. In various embodiments, the integrated container and tube sets may reduce manufacturing complexity. For example, integrally forming one or more components can reduce assembly steps. In many embodiments, the integrated container and tube sets may include containers with one or more interfaces configured to enable the container to be used in conjunction with a variety of systems and configurations. In various embodiments, components of the integrated container and tube sets may include features to reduce cleaning and/or processing time, such as between procedures. For example, coaxial tubing may reduce the amount of surface area that must be cleaned. Additionally, or alternatively, the integrated container and tube sets may include containers designed and shaped to promote efficiency and adaptability. For example, the containers may include features, such as a neck portion at gas tubing connection ports, to reduce, or prevent, flow of liquid into gas tubing. In another example, the containers may be designed such that irrigation supply tubing is coupled at the lower point of the reservoir, such as to promote the flow of liquid from the container to the irrigation supply tube. 
     In addition, and/or alternatively, in one embodiment, each of the tubes may be sealed to maintain a sterile environment prior to use (e.g., container and tubes are sealed). In addition, and/or alternatively, each of the tubes may include, for example, a one-way valve, to prevent backflow into the container during use. For example, in one embodiment, each of the tubes may include a one-way valve in the second end of the tube to prevent backflow of fluid into the container during use. In addition, and/or alternatively, one or more of the tubes may include a connector or adapter such as, for example, a Tuohy Borst connector, an adjustable connector such as, for example, stop-cock adaptor, a split connector such as, for example, a coaxial split connector or scope adapter arranged and configured to couple to the endoscope, etc. In use, the adapters may be arranged and configured in a normally closed position to maintain the sterile environment prior to use. Thereafter, during use, as needed, the user can move one or more of the adapters from the closed position to an opened position to enable flow of fluid and/or gas as needed. 
     Turning now to the Figures, various embodiments of an integrated container and tube set are illustrated for the sake of disclosing and describing informative examples without intent to limit the disclosure from the broad principles described herein.  FIGS.  5 - 7    illustrate an embodiment of an integrated container and tube set  500  formed in accordance with various principles of the present disclosure. As previously mentioned, the integrated container and tube set  500  may be used in place of the water reservoir  270  (e.g., water bottle) described above in connection with  FIGS.  1 - 4   . As illustrated in  FIGS.  5 - 7   , the integrated container and tube set  500  includes a container (e.g., a water bottle, reservoir, etc.)  520  and a plurality of tubes  530  associated with the container  520 . In one embodiment, each of the plurality of tubes  530  includes an outer wall that is continuous with the container  520 . That is, the plurality of tubes  530  may be integrally formed with the container  520  (e.g., tubes  530  may be permanently and non-separably molded to the container  520  so that there is no interconnecting removable cap between the tubes and the container such as, for example, cap or top  280 ,  310 ). 
     In one embodiment, as illustrated, the container  520  may be arranged and configured as a rigid (e.g., non-compressible) container manufactured from any suitable material now known or hereafter developed including, for example, a plastic, an elastomer, or the like. As illustrated, the container  520  may have a generally rectangular shape, although this is but one configuration and the container  520  may have other shapes such as, for example, square, cylindrical, or the like. The container  520  includes a bottom portion  522  arranged and configured to hold, receive, store, etc. a fluid such as, for example, H 2 O, and a top portion (e.g., an air gap)  524  arranged and configured to hold, receive, store, etc. a gas such as, for example, air, CO 2 , etc. so that, depending on operation of the endoscope as previously described including, for example, the user&#39;s actuation of the endoscopic valves and/or foot petals, fluid or gas can be supplied to the endoscope as needed. 
     In accordance with aspects of the present disclosure, and as previously mentioned, the tubes  530  may be integrally formed with the container  520  so that the container  520  and tubes  530  can be provided as a single fluid delivery device. The integrated container and tube set  500  may be integrally formed by any suitable method now known or hereafter developed. For example, in one embodiment, the tubes  530  may be formed at the same time as the container  520  using, for example, moldable plastic, elastomer, or the like. For example, the container  520  may be molded to each of the plurality of tubes  530 . Alternatively, the tubes  530  may be initially formed and then the container  520  may be molded around the pre-existing tubes  530  creating the integral assembly. In this manner, the tubes  530  may be manufactured from a different material than the container  520 . 
     In either event, once properly manufactured, the integrated container and tube set  500  may be filled with a fluid such as, for example, H 2 O, in the bottom portion thereof  522  and a gas such as, for example, air, in the top portion  524  thereof. The integrated container and tube set  500  may then be subsequently sealed or capped. In one embodiment, the container  520  may be filled using one or more of the integrated tubes  530  (e.g., the fluid and/or gas may be inserted into the container  520  through the second end of the integrated tubes  530 ). Alternatively, in one embodiment, the container  520  may include a supply port  526  ( FIG.  3   ) for injecting the fluid therein. That is, in one embodiment, the container  520  may include a supply port  526  such as, for example, in a bottom surface thereof, arranged and configured to couple with a fluid supply to supply fluid into the container  520 . In either event, thereafter, the integrated container and tube set  500  may be sealed or cap and then sterilized creating a sealed, integrated sterile container and tube set  500  (e.g., fluid is sealed from the surrounding atmosphere). That is, as will be described in greater detail below, each of the tubes  530  may be sealed or capped to prevent air or the like from entering into the integrated container and tube set  500 . 
     As previously mentioned, the integrated container and tube set  500  may include a plurality of tubes  530 . For example, referring to  FIGS.  5  and  7   , in one embodiment, the integrated container and tube set  500  may include first, second, third, and fourth tubes  540 ,  550 ,  560 ,  570 , although this is but one configuration and more or less tubes may be provided such as, for example, one, two, three, etc. depending on the medical procedure being performed. As illustrated, the first tube  540  may include a first end  542 , a second end  544 , and a first lumen  546  extending from the first end  542  to the second end  544 . As previously mentioned, in one embodiment, the first tube  540  is integrally formed with the container  520  (e.g., the first tube  540  includes an outer wall that is continuous with the container  520 ). With the first tube  540  passing through the container  520 , the first end  542  of the first tube  540  is arranged and configured in fluid communication with the bottom portion  522  of the container  520  while the second end  544  of the first tube  540  is arranged and configured to extend external from the container  520  so that the second end  544  is positioned external to the container  520 . Thus arranged, the first tube  540  is arranged and configured to supply fluid to the endoscope. In one embodiment, as previously described above in connection with  FIGS.  1 - 4   , the first tube  540  may be arranged and configured to be operatively coupled to a pump (e.g., peristaltic pump) so that fluid can be sucked from the container  520  to provide irrigation (e.g., lower pressure, higher volume water may be provided by utilizing a pump to suck water from the container  520 ). That is, the second end  544  of the first tube  540  may be operatively coupled to a pump (e.g., peristaltic pump) so that the first lumen  546  is arranged and configured to fluidly couple to an irrigation channel of the endoscope for supplying fluid (e.g., H 2 O) from the container  520  to the irrigation channel of the endoscope as needed. In this manner, the first tube  540  may also be referred to as an irrigation supply tube. 
     In one embodiment, the integrated container and tube set  500  may also include a second tube  550  including a first end  552 , a second end  554 , and a second lumen  556  extending from the first end  552  to the second end  554 . As previously mentioned, in one embodiment, the second tube  550  is integrally formed with the container  520  (e.g., the second tube  550  includes an outer wall that is continuous with the container  520 ). With the second tube  550  passing through the container  520 , the first end  552  of the second tube  550  is arranged and configured in fluid communication with the bottom portion  522  of the container  520  while the second end  554  of the second tube  550  is configured to extend external from the container  520  so that the second end  554  of the second tube  550  is positioned external to the container  520 . Thus arranged, the second tube  550  is arranged and configured to supply fluid to the endoscope. In one embodiment, as previously described above in connection with  FIGS.  1 - 4   , depending on actuation of the various valves on the endoscope by the surgeon, the second tube  550  may be arranged and configured to wash, clean, or the like, the lens of the endoscope (e.g., to provide fluid across an imaging lens of the endoscope). In this manner, the second tube  550  may also be referred to as a lens wash supply tube. 
     In one embodiment, the integrated container and tube set  500  may also include a third tube  560  including a first end  562 , a second end  564 , and a third lumen  566  extending from the first end  562  to the second end  564 . As previously mentioned, in one embodiment, the third tube  560  is integrally formed with the container  520  (e.g., the third tube  560  includes an outer wall that is continuous with the container  520 ). With the third tube  560  passing through the container  520 , the first end  562  of the third tube  560  is arranged and configured in operatively communication with the top portion  524  of the container  520  while the second end  564  of the third tube  560  is arranged and configured to extend external from the container  520  so that the second end  564  is positioned external to the container  520 . Thus arranged, the third tube  560  is arranged and configured to supply air to the endoscope. For example, in one embodiment, as previously described above in connection with  FIGS.  1 - 4   , the third tube  560  may be operatively coupled to a pump (e.g., an air pump). In one embodiment, the third tube  560  may be arranged and configured to work in conjunction with the second tube  550 . That is, depending on, inter alia, actuation of the valves on the endoscope by the surgeon, air may be supplied from the pump to the container  520  via the third tube  560  to pressurize the container  520  to push fluid through the second lumen  550  to lens wash. Alternatively, depending on, inter alia, actuation of the valves on the endoscope by the surgeon, air may be supplied from the pump via the third tube  560  to the endoscope to insufflate the patient with air. Thus, in one configuration, in use, the second and third tubes  550 ,  560  (e.g., second and third lumens  556 ,  566 ) may be utilized to pressurize the container  520  with air to supply fluid (H 2 O) to the endoscope for cleaning the lens (e.g., lens wash). Alternatively, in another configuration, in use, the third tube  560  (e.g., third lumen  566 ) may be utilized to supply air to the patient for insufflation. Thus arranged, the third tube  560  may be referred to as a gas supply tube. 
     In one embodiment, as best illustrated in  FIG.  7   , the second or lens wash supply tube  550  and the third or gas supply tube  560  (e.g., second and third lumens  556 ,  566 ) may be combined into a single, multi-lumen tube. Thus arranged, in one embodiment, the second lumen  556  may be coaxial with the third lumen  566 . For example, the second lumen  556  may be disposed or positioned within the third lumen  566 . Alternatively, however, the second and third lumens  556 ,  566  may be disposed adjacent to each other in, for example, a side-by-side relationship. For example, in one embodiment, the multi-lumen tube may include an internal wall extending along a length thereof between the second lumen  556  and the third lumen  566 . 
     Thus arranged, the second lumen  556  is arranged and configured to extend from the second end of the multi-lumen tube to the first end of the multi-lumen tube so that the second lumen  556  is arranged and configured to be in fluid communication with the bottom portion  522  of the container  520 . The third lumen  566  is arranged and configured to extend from the second end of the multi-lumen tube towards the first end of the multi-lumen tube. However, the third lumen  566  is arranged and configured to be in operatively communication with the top portion  524  of the container  520  (e.g., the third lumen  566  does not extend as far longitudinally into the container  520  as the second lumen  556 ). 
     With continued reference to  FIGS.  5 - 7   , in one embodiment, the integrated container and tube set  500  may also include a fourth tube  570  having a first end  572 , a second end  574 , and a fourth lumen  576  extending from the first end  572  to the second end  574 . As previously mentioned, in one embodiment, the fourth tube  570  is integrally formed with the container  520  (e.g., the fourth tube  570  includes an outer wall that is continuous with the container  520 ). With the fourth tube  570  passing through the container  520 , the first end  572  of the fourth tube  570  is arranged and configured in operative communication with the top portion  524  of the container  520  while the second end  574  of the fourth tube  570  is arranged and configured to extend external from the container  520  so that the second end  574  is positioned external to the container  520 . 
     In use, in one embodiment and as previously described above in connection with  FIGS.  1 - 4   , the fourth lumen  576  may be arranged and configured to work in conjunction with the third lumen  566 . For example, in one embodiment, with the pump coupled to the gas supply tube  560  turned off, the fourth lumen  576  may be operatively coupled to a gas source such as, for example, a CO 2  source. Thereafter, with the air pump turned off, CO 2  may be supplied from the CO 2  source into the container  520  via the fourth tube  570  to pressurize the container  520  with CO 2  which may then be supplied to the endoscope via the gas supply tube  560  to insufflate the patient with CO 2  by passing the CO 2  through the endoscope in a controlled manner into the target space (e.g., with the pump coupled to the gas supply tube  560  in the off position, CO 2  may be supplied from the CO 2  source to the container  520  via the fourth tube  570 , which causes the container  520  to pressurize resulting in CO 2  being supplied to the endoscope via the third or gas supply tube  560 ). Thus arranged, the fourth tube may be referred to as an alternative gas supply tube (e.g., CO 2 ). 
     With continued reference to  FIGS.  5 - 7    and as will be described in greater detail below, in one embodiment, each of the plurality of tubes  530  may be sealed, capped, or the like to maintain a sterile environment prior to use. For example, each of the plurality of tubes  530  may include a seal  580  formed in or along the second end thereof to prevent fluid, moisture, air, etc. from entering into the container  520 . Additionally, one or more tubes of other embodiments, such as those described with respect to  FIGS.  11 A- 11 C and/or  14 A- 14 B , may incorporate one or more of the aspects and/or components to maintain a sterile environment without departing from this disclosure. 
     In addition, and/or alternatively, each of the plurality of tubes  530  may include, for example, a one-way valve  585  in the second end thereof. In use, the one-way valves  585  prevents backflow of fluid into the container  520 . That is, incorporation of a one-way valve  585  into each of the second ends  544 ,  554 ,  564 ,  574  of the first, second, third, and fourth tubes  540 ,  550 ,  560 ,  570  ensures that the tubes are sealed to the surrounding environment ensuring that the container  520  remains sterile until operation. In one embodiment, the one-way valve  585  may be in the form of, for example, a Tuohy Borst adapter. In one embodiment, as will be described in greater detail below, in use, the one-way valves  585  may be arranged and configured to puncture or pierce the seal  580  formed in the tubes  530  when the one-way valves  585  are coupled thereto. For example, the one-way valves  585  may include a piercing or puncturing member for piercing the seal  580 . Thus arranged, in use, coupling of the one-way valves  585  to the second ends  544 ,  554 ,  564 ,  574  of the first, second, third, and fourth tubes  540 ,  550 ,  560 ,  570  pierces the seal  580  formed in the tubes. 
     In addition, and/or alternatively, as illustrated, the second end of one or more of the plurality of tubes  530  may include, for example, an adapter, a connector, or the like  588  or the like, coupled to the second end thereof, either directly or indirectly via, for example, the one-way valve  585 . That is, in one embodiment, the adapter  588  may be coupled directly to one or more of the second ends of the tubes. Alternatively, in one embodiment, the adapter  588  may be coupled to one or more of the one-way valves  585 , which may be coupled to one or more of the second ends of the tubes. In one embodiment, in use, the adapter  588  may be arranged and configured to puncture or pierce the seal  580  formed in the tubes  530  when coupled directly thereto. For example, the adapter  588  may include a piercing or puncturing member for piercing the seal  580 . Thus arranged, in use, coupling of the adapter  588  to the second ends of the tubes may pierce the seal  580  formed in the tubes. 
     In one embodiment, the adapter  588  may be in the form of, for example, an adjustable connector. For example, in one embodiment, as illustrated, the adapter  588  may be in the form of a stop-cock adaptor. In use, the stop-cock adaptor may be coupled, directly or indirectly, to the second end of one or more of the tubes  530 . For example, as illustrated, in use, the alternative gas supply tube  570  may include a stop-cock adaptor. In use, a stop-cock adaptor may be manipulated by a user from a closed position to an opened position. Thus arranged, the user can enable gas and/or fluid flow through the respective tube by manipulating the stop-cock adaptor between the closed and opened positions. For example, in connection with the illustrated embodiment, the user may move the stop-cock adaptor from the closed position to the opened position to enable gas (e.g., CO 2 ) to flow from the CO 2  source into the container  520  via the alternative gas supply tube  570  to pressurize the container  520 . 
     Alternatively, in one embodiment, the adapter  588  may be in the form of a coaxial split connector  590  coupled to the tube, either directly or indirectly. For example, in connection with the illustrated embodiment, a coaxial split connector  590  may be coupled, directly or indirectly, to the second end of the multi-lumen tube (e.g., the lens wash supply tube  550  and the gas supply tube  560 ) so that the second and third lumens  556 ,  566  may be coupled to the endoscope via the coaxial split connector  590 . Thus arranged, in use, the coaxial split connector  590  is arranged and configured to couple to the endoscope so that fluid and gas may be exchanged with the endoscope. For example, in one embodiment, the coaxial split connector  590  may be arranged and configured to supply fluid and/or gas from the container  520  to the endoscope via the second and third lumens  556 ,  566 , although this but one configuration. In one embodiment, the coaxial split connector  590  may be arranged and configured as, for example, a T-connector. The coaxial split connector  590  may be arranged and configured as an elastic or plastic end connector, to enable the second end of the tube to be coupled to, for example, the endoscope, gas source, or the like as needed. Alternatively, in one embodiment, the coaxial split connector  590  may be overmolded onto the tube, etc. 
     Thereafter, in use, with the integrated container and tube set  500  coupled to the endoscope, gas (CO 2 ) source, air pump, etc., the surgeon can operate, open, etc. the one-way valves, etc. to allow fluid and/or gas to flow. Subsequently, when demanded by the endoscope (e.g., when the surgeon actuates one or more of the various valves on the endoscope as—previously described in connection with  FIGS.  14   ), fluid and/or gas can be supplied to the endoscope depending on the procedural being performed. 
     Referring to  FIG.  8 A , an alternate embodiment of an integrated container and tube set  600  is disclosed. In accordance with one or more aspects of the present invention, the integrated container and tube set  600  is substantially similar to the integrated container and tube set  500  disclosed above in connection with  FIGS.  4 - 7    except as outlined herein. Thus for the sake of brevity, detailed description of similar elements is omitted herefrom. 
     In accordance with one or more aspects of the present invention, the integrated container and tube set  600  includes a container  620  and a plurality of tubes  630 . However, in contrast to the container  520  described above in connection with  FIG.  5 - 7   , the container  620  may be arranged in a non-rigid configuration (e.g., the container  620  may be arranged and configured as a compressible container). For example, the container  620  may be in the form of a pouch, a bag, or other soft fluid container similar to a saline style pouch (such terms being used interchangeably without intent to limit or otherwise convey different meaning or intent). Thus arranged, the non-rigid container  620  may be referred to as a pouch herein. In accordance with this embodiment, the tubes  630  may be molded to the pouch  620  while the pouch  620  is being manufactured. Thus arranged, the pouch  620  and tubes  630  may be manufactured from a suitable uniform material including, for example, plastics, elastomers, or any other suitable material now known or hereafter developed. Alternatively, in one embodiment, the pouch  620  may be separately formed from the tubes  630 . For example, in one embodiment, the tubes  630  may be formed and the pouch  620  may be subsequently molded around the tubes  630 . Thus arranged, a combined assembly could be manufactured. In this embodiment, the pouch  620  and tubes  630  may be manufactured from a suitable uniform material. Alternatively, the pouch  620  and tubes  630  could be manufactured from different materials. 
     Alternatively, referring to  FIG.  8 B , in one embodiment, the tubes  630  may be separately manufactured from the pouch  620 . That is, the tubes  630  may be reversibly coupled to the pouch  620  (e.g., tubes  630  are arranged and configured to be inserted into the pouch  620  and may, in one embodiment, be removable therefrom). For example, in one embodiment, each of the tubes  630  may include a first end  632  including a piercing or penetrating member  634  arranged and configured to pierce a membrane or surface of the pouch  620  as the tubes  630  are being inserted, pressed, etc. into the pouch  620  to enable fluid and/or gas flow, as previously described. That is, in use, the first end  632  of the tubes  630  may include a piercing or penetrating member  634  such as, for example, a sharp tip or the like. Thus arranged, in use, the operating staff may insert one or more tubes  630  into the pouch  620  for supplying fluid and/or gas to the endoscope as desired. 
     In addition, and/or alternatively, in one embodiment, the plurality of tubes  630  may be arranged and configured as a multi-lumen tube. For example, the first irrigation supply tube, the second lens wash supply tube, the third gas supply tube, and the optional fourth alternative gas supply tube may be arranged and configured as a single tube at least along the first end thereof (e.g., a wall of each of the tubes may be coupled or integrally formed with each other). Alternatively, the first irrigation supply tube, the second lens wash supply tube, the third gas supply tube, and the optional fourth alternative gas supply tube may be separately formed and coupled together, or may remain separate and distinct with respect to each other. 
     In accordance with one or more aspects of the present disclosure, the pouch  620  can be filled during molding operations or post-molding operations. Thereafter, similar to the integrated container and tube set  500  previously described, the pouch  600  including the container  620  and tubes  630  may be used in place of the water reservoir  270  (e.g., water bottle) described above in connection with  FIGS.  1 - 4   . 
     Referring to  FIGS.  9 - 10 B , an alternate embodiment of an integrated container and tube set  700  is disclosed. In accordance with one or more aspects of the present invention, the integrated container and tube set  700  is substantially similar to the integrated container and tube sets  500  disclosed above in connection with  FIGS.  4 - 7    except as outlined herein. Thus for the sake of brevity, detailed description of similar elements is omitted herefrom. 
     In accordance with one or more aspects of the present disclosure, the integrated container and tube set  700  includes a container  720  and a plurality of tubes  730 . As illustrated, each of the tubes  730  may include a first end  732  disposed within the container  720  and a second end  734  positioned external to the container  720 . In accordance with one or more aspects of the present disclosure, the second end  734  of the tubes  730  such as, for example, the second ends of the first irrigation supply tube, the second lens wash supply tube, the third gas supply tube, and the optional fourth alternative gas supply tube may be capped, closed, sealed, or the like  780  (such terms being used interchangeably without intent to limit or otherwise convey different meaning or intent) during manufacturing to create a permanent sealed assembly. Thereafter, in use, the second end  734  of the tubes  730  may be punctured by, for example, a piercing or penetrating member. For example, in one embodiment, the piercing or penetrating member may be in the form of one or more of the one-way valves, connectors, coaxial split connectors, or the like coupled to the second end  734  of the tubes  730 . For example, in one embodiment and as schematically illustrated in  FIGS.  10 A and  10 B , the coaxial split connector  590  may be arranged and configured to pierce or penetrate the sealed portion when the coaxial split connector  590  is coupled to the second end  734  of the tube. 
     The capped or sealed portion  780  may be configured along any length of the tube  730 . For example, in one embodiment and as generally illustrated, the capped or sealed portion  780  may be positioned adjacent to an end portion of the second end  734  of the tubes  730 , or at some point inside of the tube  730 . In use, the valves, connectors, adapters, or the like may be arranged and configured to couple to the tube  730  via any suitable mechanism or method now known or hereafter developed. For example, the valves, connectors, or adapters may be press-fitted onto the tubes  730 . Alternatively, anchoring methods such as, luer fittings, threaded connections, or the like, may be utilized. In either event, once coupled to the tubes  730 , the valves, connectors or adapters are arranged and configured to create a seal with the tube  730  to prevent leaks at the puncture point. 
     Referring to  FIGS.  11 A- 11 C , various embodiments of an integrated container and tube set  1100 A,  1100 B,  1100 C are disclosed. In accordance with one or more aspects of the present invention, the integrated container and tube sets  1100 A,  1100 B,  1100 C may be substantially similar to the integrated container and tube sets  500 ,  600 ,  700 ,  1400 A,  1400 B disclosed in connection with  FIGS.  4 - 10 A and  14 A- 14 B  except as outlined herein Similarly, in accordance with one or more aspects of the present invention, one or more components, or features, of the integrated container and tube sets  1100 A,  1100 B,  1100 C may be substantially similar to each other except as outlined herein. Thus for the sake of brevity, detailed description of similar elements may be omitted herefrom. 
     Generally,  FIGS.  11 A- 11 C  illustrate an integrated container and tube set (i.e.,  1100 A,  1100 B, or  1100 C) that includes a gas/lens wash connection  1190 , coaxial tubing  1110 , a container (i.e.,  1120   a    1120   b,  or  1120   c ), upstream irrigation supply tubing  1119 , an irrigation pump  1115 , downstream irrigation supply tubing  1155   c,  an irrigation connection  1193 , alternative gas supply tubing  1170 , and an alternative gas connection  1125 . Some embodiments may not include an alternative gas supply tubing  1170  or an alternative gas connection  1125  (see e.g.,  FIG.  11 C ). As shown in  FIGS.  11 A and  11 B , gas/lens wash connection  1190  and irrigation connection  1193  may by removably couplable to connector portion  1165 . 
     In many embodiments, connector portion  1165  may be the same or similar to connector portion  265 , such as in  FIGS.  2  and  4   . In some embodiments, gas/lens wash connection  1190  may include a coaxial split connector having first and second opening. In some such embodiments, the first opening is in fluid communication with an inner tube of the coaxial tube (e.g., lens wash supply tubing  1145   c ) and the second opening is in fluid communication with an outer tube of the coaxial tube (e.g., gas supply tubing  1140   c ). 
     In  FIG.  11 A , the container  1120   a  may include an upper half  1143   a,  a lower half  1147   a,  and interfaces  1160   a,    1160   b.  In  FIG.  11 B , the container  1120   b  may include upper half  1143   b,  lower half  1147   b,  and interface  1171   a,    1171   b.  In  FIG.  11 C , the container  1120   c  may include upper half  1143   c,  lower half  1147   c,  and interface  1180 . More generally, the upper halves of the containers may include a fill port  1102 . In many embodiments, the fill port  1102  may be resealable. For example, fill port  1102  may include a removable cap or openable valve. In some embodiments, the fill port  1102  may include a check valve, such as in the removable cap. More generally, in various embodiments, a check valve may be included in the upper half of a container configured to equalize with atmospheric pressure. For example, when a rigid container is utilized a check valve may be included to prevent or limit a negative pressure differential with the atmosphere. The coaxial tubing  1110  and the alternative gas supply tubing  1170  may be coupled to the upper halves. In many embodiments, the outer tube of coaxial tubing  1110  (e.g., gas supply tubing  1140   c ) may couple to and terminate in the upper half of the container (e.g.,  1143   a  of  FIG.  11 A ) while the inner tube of coaxial tubing  1110  (e.g., lens wash tubing  1145   c ) may extend into and terminate in the lower half of the container (e.g.,  1147   a  of  FIG.  11 A ). 
     In various embodiments, one or more portions of the coaxial tubing  1110  and/or the alternative gas supply tubing  1170  may be integrally formed with the container. The upstream irrigation supply tubing  1119  may be coupled to the lower halves. In some embodiments, one or more portions of the irrigation supply tubing may be integrally formed with the container  1120   a,    1120   b,    1120   c.    
     A liquid in a bottom portion  1122  of the containers may flow into either the upstream irrigation supply tubing  1119  or the lens wash tubing  1145   c.  In many embodiments, a gas may be introduced into a top portion  1124  of the containers, such as via gas supply tubing  1140   c  or alternative gas connection  1125 , to force the liquid to flow into the lens wash tubing  1145   c.  In some embodiments, irrigation pump  1115  may be utilized to draw liquid from the container via upstream irrigation supply tubing  1119  and pump the liquid to the irrigation connection  1193  via downstream irrigation supply tubing  1155   c.  In many embodiments, irrigation pump  1115  many include a peristaltic pump. In some embodiments, the upstream irrigation supply tubing  1119  may be more rigid or robust than the downstream irrigation supply tubing. For example, upstream irrigation supply tubing may be more resistant to collapse than the downstream irrigation supply tubing. 
     Referring specifically to  FIG.  11 A , the container  1120   a  may be shaped such that upstream irrigation supply tubing couples to the container at a lowest point. The container  1120   a  may also include a downward wedge shape to facilitate the flow of fluid into the irrigation supply tubing. In some embodiments, container  1120   a  may include a width that is greater than its depth. For example, the width may be chosen to match the width of another component (e.g., irrigation pump, video processing unit, or cart) along with a narrow profile to provide an efficient and space saving configuration. In many embodiments, the container shape is chosen based on the component, or components, the interfaces are configured to couple to. The container  1120   a  may include one or more interfaces to couple with one or more of one or more of a mount, a hanger, and a holder. For example, interfaces  1160   a,    1160   b  may include flat hooks that can couple to another component such as a pump, a video processing unit, or a cart. 
     Additionally, container  1120   a  may include a neck portion where the gas supply tubing  1140   c  and the alternative gas supply tubing  1170  couple to the container  1120   a.  In various embodiments, the neck portion may reduce, or prevent, flow of liquid  1122  from the container  1120   a  into the gas supply tubing  1140   c  and the alternative gas supply tubing  1170 . In some embodiments, the container  1120   a  may be made from a rigid material. In another embodiment, the container  1120   a  may be made from a flexible material. In another such embodiment, the container  1120   a  may be collapsible. In many embodiments, the neck portion may be made from a more flexible material than the remainder of the container  1120   a.    
     Referring specifically to  FIG.  11 B , the container  1120   b  may include one or more interfaces to couple with one or more of one or more of a mount, a hanger, and a holder. For example, interfaces  1171   a,    1171   b  may include loops or handles that can be used for hanging the container  1120   b,  such as from an intravenous (IV) stand. In many embodiments, the interfaces  1171   a,    1171   b  may be integrally formed with the container  1120   b.  In the illustrated embodiment, the interfaces  1171   a,    1171   b  are disposed symmetrically with respect to a center line of the container  1120   b.    
     Referring specifically to  FIG.  11 C , the container  1120   c  may include one or more interfaces to couple with one or more of a mount, a hanger, and a holder. For example, interface  1180  may include a loop or handle that can be used for hanging the container  1120   c,  such as from an IV stand. In many embodiments, the interface  1180  may be integrally formed with the container  1120   c.  In some embodiments, the fill port  1102  of container  1120   c  may be on a face. In some such embodiments, positioning the fill port  1102  on the front face may reduce the height required to refill the container  1120   c  and/or facilitate collapsibility of the container  1120   c,  such as by enabling it to fold flatter. In many embodiments, container  1120   c  is made from a flexible material. For example, container  1120   c  may be similar to an IV bag. 
       FIG.  12    depicts a container  1220  in a first state  1250 - 1  and in a second state  1250 - 2 , according to an embodiment of the present disclosure. The container  1220  may be collapsible. Accordingly, state  1250 - 1  may represent an expanded state and state  1250 - 2  may represent a collapsed state. As previously mentioned, collapsibility may reduce storage space requirements. Further, collapsibility may reduce storage space requirements without sacrificing fluid holding capacity. More generally, the containers described hereby may include a capacity above 1 liter. For example, a container may have a capacity between 3 and 5 liters. In another example, a container may have a capacity of up to 8 liters. As previously mentioned, one or more containers described hereby may be flexible and/or collapsible. In some embodiments, the curved design of the necking portion may reduce, or prevent, flow of liquid from the container into gas supply tubes connected thereto. 
       FIG.  13    depicts a container  1320  with a neck portion, according to an embodiment of the present disclosure. In various embodiments, the staged design of the neck portion may reduce, or prevent, flow of liquid into the gas supply tubes connectable thereto. For example, the gradual, or stepped, reduction in diameter of the neck portion in the upper half of the container  1320 . In some embodiments, an interface may be integrated into the neck portion. In one embodiment, the interface may include threads in the neck portion. For example, the threads may be utilized to couple with an interface of an endoscopic system. 
     Referring to  FIGS.  14 A and  14 B , embodiments of an integrated container and tube sets  1400 A,  1400 B are disclosed. In accordance with one or more aspects of the present invention, the integrated container and tube sets  1400 A,  1400 B may be substantially similar to the integrated container and tube sets  500 ,  600 ,  700 ,  1100 A,  1100 B,  1100 C disclosed above in connection with  FIGS.  4 - 11 C , except as outlined herein Similarly, in accordance with one or more aspects of the present invention, one or more components, or features, of the integrated container and tube sets  1400 A,  1400 B may be substantially similar to each other except as outlined herein. Thus, for the sake of brevity, detailed description of similar elements may be omitted herefrom. 
     Generally,  FIGS.  14 A and  14 B  illustrate an integrated container and tube set (i.e.,  1400 A or  1400 B) that includes connector portion  1465 , coaxial tubing  1410  with gas supply tubing  1440   c  and lens wash tubing  1445   c,  gas source supply tubing  1469 , container  1420   a,    1420   b  with upper half  1443  and lower half  1447 , upstream irrigation supply tubing  1419 , irrigation pump  1415 , and downstream irrigation supply tubing  1455   c.  Additionally, the container  1420   a,    1420   b  may include fill port  1402  and interface  1490 . In many embodiments, connector portion  1465  may be the same or similar to connector portion  265 , such as in  FIGS.  2  and  4   . The integrated container and tube set  1400 A includes features to maintain a gas pressure within at least a portion of the container  1420   a.  The integrated container and tube set  1400 B includes features to facilitate quick pressure buildup within at least a portion of the container  1420   b.  In many embodiments, these features may be used separately, or in combination, to reduce lag in lens wash functionality provided via lens wash tubing  1445   c.  For example, maintaining a gas pressure within at least a portion of the container reduces the amount of gas that must be introduced into the portion of the container (e.g., into top portion  1424 ) in order to make a liquid (e.g., in bottom portion  1422 ) flow up the lens wash tubing  1445   c,  out of the container, and out of a lens wash outlet (e.g., gas/lens wash outlet  220  of  FIG.  2   ). Accordingly, various embodiments may have a response time for the lens wash functionality of five seconds or less, such as one second. In various embodiments, the response time may refer to an amount of time from activating the lens wash functionality (e.g., by depressing gas/water valve  140  of  FIG.  2   ) until liquid begins to flow out of the endoscopic system (e.g., via gas/lens wash outlet  220  of  FIG.  2   ). 
     In  FIG.  14 A , a check valve  1499   a  is included wherein the gas supply tubing  1440   c  couples to the container  1420   a.  In various embodiments, the check valve  1499   a  may prevent gas from escaping the top portion  1424  of the container  1420   a.  In other words, the check valve  1499   a  may only allow flow from the gas supply tubing  1440   c  (e.g., air from connector  1465  or CO 2  from gas source supply tubing  1469 ) into the interior of the container  1420   a.  In many embodiments, a pressure inside the top portion  1424  may remain closer to a pressure necessary to force liquid in the bottom portion  1422  up the lens wash tubing  1445   c  and out of the container  1420   a  due to the check valve  1499   a.  Accordingly, lens wash functionality may be more responsive than if the pressure in the container had to be built up from a lower pressure (e.g., as a result of pressure bleeding to atmosphere when a physician is calling for neither air, nor lens watch with the air/water valve on the endoscope). For example, check valve  1499   a  may enable the container  1420   a  to remain at a pressure between 1 and 8 psi (above atmospheric pressure), instead of falling back to atmospheric pressure. 
     Additionally, in integrated container and tube set  1400 A, a gas, may be provided via the gas source supply tubing  1469  instead of via connector portion  1465  or via an alternative gas supply tube as described above. In some such embodiments, the gas source supply tubing  1469  may effectively be the same as an alternative gas supply tube, the only difference being that gas may not be provided via a connector portion, such as from pressurizing pump  215  of endoscopic system  200 . More generally, various embodiments described hereby may function in this manner without departing from the scope of this disclosure. In some such embodiments, a pressurizing pump separate from connector  1465  may be attached to the gas source supply tubing  1469 . In other such embodiments, a pressurized cannister (e.g., of air, oxygen, CO 2 , etcetera) may be attached to the gas source supply tubing Similarly, integrated container and tube sets  1400 A,  1400 B may utilize a connector portion  1465  and/or an alternative gas supply tube without departing from the scope of this disclosure. 
     In some embodiments, a coaxial split connector may be utilized to couple coaxial tubing  1410  with container  1420   a.  The coaxial split connector may enable a standard check valve to be utilized. Alternatively, an umbrella style check valve could be used while the gas supply tubing  1440   c  and lens wash tubing  1445   c  remained coaxial. 
     In  FIG.  14 B , the container  1420   b  includes a first chamber  1437 - 1  and a second chamber  1437 - 2 . The first chamber  1437 - 1  may be connected to the second chamber  1437 - 2  via a side channel  1433 . The side channel  1433  may include a check valve that only allows flow from the second chamber  1437 - 2  to the first chamber  1437 - 1 . Container  1420   b  may include the first chamber  1437 - 1  to provide a small volume in which to build pressure by introducing gas via gas supply tubing  1440   c,  but at the same time container  1420   b  facilitates a larger overall volume of available liquid in chamber  1437 - 2 . 
     In many embodiments, with the much smaller first chamber  1437 - 1 , there is less volume of air in which to build pressure to deliver lens wash, even if the water level has already been drawn down to low level, e.g., less than quarter of the second chamber  1437 - 2 . In this way undesirably long response time between calling for lens wash and delivering to scope is prevented. 
     In several embodiments, once the pressure in chamber  1437 - 1  falls low enough, the head pressure created by having a higher level of fluid in chamber  1437 - 2  may create a flow from the second chamber  1437 - 2  into the first chamber  1437 - 1  to refill the first chamber  1437 - 1  back to a level equal to the second chamber  1437 - 2 . Additionally, or alternatively, when the container is sufficiently flexible, the second chamber  1437 - 2  may be squeezed manually to force water from the second chamber  1437 - 2  into the first chamber  1437 - 1 . Accordingly, the container  1420   b  may be flexible and/or collapsible. In some embodiments a second check valve may be included such as described with respect to  FIG.  14 A . In some such embodiments, an umbrella style check valve may be utilized in coaxial tubing  1410 . A fill port  1402  in second chamber  1437 - 2  allows for that chamber to be refilled. In many embodiments, fill port  1402  is the same or similar to fill port  1102 . If the container  1420   b  is sufficiently flexible, pressure can be drawn down in the second chamber  1437 - 2  by operation of the irrigation pump  1415 , collapsing the second chamber  1437 - 2 , without affecting pressure in the first chamber  1437 - 1 . If the container  1420   b  is more rigid, and collapsing of the container is not desired, then a one-way vent can be included in the second chamber (e.g., as part of the fill port  1402 ) to allow atmospheric air to be pulled into the chamber when the irrigation pump is operating, thus keeping the pressure at a level that the second chamber doesn&#39;t collapse. In either case, the pressure in the first chamber is unaffected because check valve  1199   b  presents liquid from being pulled from the first chamber into the second chamber. 
     In the illustrated embodiment, the side channel  1433  includes a u-shaped connection between the first chamber  1437 - 1  and second chamber  1437 - 2 . However, the side channel  1433  may be configured in a variety of ways without departing from the scope of this disclosure. For example, the side channel  1433  may be positioned against, or within, the bottom wall of the container  1420   b.  In another example, the side channel  1433  may include an opening in the wall dividing the first and second chambers  1437 . In such examples, check valve  1499   b  may be disposed in the opening in the wall. In many embodiments, the side channel  1433  may be integrally formed with the container  1420   b.  In one embodiment, a side channel may not be included. For example, each chamber may have a separate fill port. In some embodiment, the side channel  1433  may be included along with separate fill ports for both chambers to provide different avenues for refilling first chamber  1437 - 1 . In one embodiment, the first chamber  1437 - 1  may have a capacity between 0.5 and 2 liters, such as 1 liter, and the second chamber  1437 - 2  may have a capacity between 1.5 and 8 liters, such as 4 liters. 
     Exemplary devices, systems, and methods with which embodiments of the present disclosure may be implemented include, but are not limited to, those described in U.S. Patent Application having Attorney Docket No. 8150.0745, titled “Tubing Assemblies and Methods for Fluid Delivery”, filed even date herewith, the complete disclosure of which is incorporated by reference herein in its entirety. 
     As will be appreciated, the lengths of irrigation, lens wash, gas supply, alternate gas supply tubing may have any suitable size (e.g., diameter). In addition, the sizing (e.g., diameters) of the tubing may vary depending on the application. In one non-limiting embodiment, the irrigation supply tubing may have an inner diameter of approximately 6.5 mm and an outer diameter of 9.7 mm. The lens wash supply tubing may have an inner diameter of approximately 5 mm and an outer diameter of 8 mm. The gas supply tubing may have an inner diameter of approximately 2 mm and an outer diameter of 3.5 mm. The alternative gas supply tubing may have an inner diameter of approximately 5 mm and an outer diameter of 8 mm. 
     It will be apparent to those skilled in the art that various modifications and variations can be made to the disclosed device without departing from the scope of the disclosure. Other embodiments of the disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the invention being indicated by the following claims. 
     All apparatuses and methods discussed herein are examples of apparatuses and/or methods implemented in accordance with one or more principles of this disclosure. These examples are not the only way to implement these principles but are merely examples. Thus, references to elements or structures or features in the drawings must be appreciated as references to examples of embodiments of the disclosure, and should not be understood as limiting the disclosure to the specific elements, structures, or features illustrated. Other examples of manners of implementing the disclosed principles will occur to a person of ordinary skill in the art upon reading this disclosure. 
     In the foregoing description and the following claims, the following will be appreciated. The phrases “at least one”, “one or more”, and “and/or”, as used herein, are open-ended expressions that are both conjunctive and disjunctive in operation. The term “a” or “an” entity, as used herein, refers to one or more of that entity. As such, the terms “a” (or “an”), “one or more” and “at least one” can be used interchangeably herein. All directional references (e.g., proximal, distal, upper, lower, upward, downward, left, right, lateral, longitudinal, front, back, top, bottom, above, below, vertical, horizontal, radial, axial, clockwise, counterclockwise, and/or the like) are only used for identification purposes to aid the reader&#39;s understanding of the present disclosure, and/or serve to distinguish regions of the associated elements from one another, and do not limit the associated element, particularly as to the position, orientation, or use of this disclosure. Connection references (e.g., attached, coupled, connected, and joined) are to be construed broadly and may include intermediate members between a collection of elements and relative movement between elements unless otherwise indicated. As such, connection references do not necessarily infer that two elements are directly connected and in fixed relation to each other. Identification references (e.g., primary, secondary, first, second, third, fourth, etc.) are not intended to connote importance or priority, but are used to distinguish one feature from another. 
     The foregoing discussion has been presented for purposes of illustration and description and is not intended to limit the disclosure to the form or forms disclosed herein. It will be understood that various additions, modifications, and substitutions may be made to embodiments disclosed herein without departing from the concept, spirit, and scope of the present disclosure. In particular, it will be clear to those skilled in the art that principles of the present disclosure may be embodied in other forms, structures, arrangements, proportions, and with other elements, materials, and components, without departing from the concept, spirit, or scope, or characteristics thereof. For example, various features of the disclosure are grouped together in one or more aspects, embodiments, or configurations for the purpose of streamlining the disclosure. However, it should be understood that various features of the certain aspects, embodiments, or configurations of the disclosure may be combined in alternate aspects, embodiments, or configurations. One skilled in the art will appreciate that the disclosure may be used with many modifications of structure, arrangement, proportions, materials, components, and otherwise, used in the practice of the disclosure, which are particularly adapted to specific environments and operative requirements without departing from the principles of the present disclosure. For example, elements shown as integrally formed may be constructed of multiple parts or elements shown as multiple parts may be integrally formed, the operation of elements may be reversed or otherwise varied, the size or dimensions of the elements may be varied, and features and components of various embodiments may be selectively combined. The presently disclosed embodiments are therefore to be considered in all respects as illustrative and not restrictive, the scope of the claimed invention being indicated by the appended claims, and not limited to the foregoing description. 
     The following claims are hereby incorporated into this Detailed Description by this reference, with each claim standing on its own as a separate embodiment of the present disclosure. In the claims, the term “comprises/comprising” does not exclude the presence of other elements or steps. Furthermore, although individually listed, a plurality of means, elements or method steps may be implemented by, e.g., a single unit or processor. Additionally, although individual features may be included in different claims, these may possibly advantageously be combined, and the inclusion in different claims does not imply that a combination of features is not feasible and/or advantageous. In addition, singular references do not exclude a plurality. The terms “a”, “an”, “first”, “second”, etc., do not preclude a plurality. Reference signs in the claims are provided merely as a clarifying example and shall not be construed as limiting the scope of the claims in any way.