A sheath configured to receive an insertion tube of an endoscope for the use of an ureteroscopy procedure comprising: a sheath body (13; 113; 213; 313; 413; 513; 613; 713) having a length; an inlet at a proximal end of the sheath body 13; 113; 213; 313; 413; 513; 613; 713); an outflow port at the proximal end of the sheath body (13; 113; 213; 313; 413; 513; 613; 713); a region including a plurality of outflow channels (32, 332, 344) which extend along the length of the sheath body (13; 113; 2013; 313; 413; 513; 613; 713) wherein the region is configured to remove debris from an anatomical region of interest during active fluid outflow; and a plurality of radially expandable flexible members (26; 126; 226; 326; 426; 526; 626; 726) which extend along the length of the sheath body (13; 113; 213; 313; 413; 513; 613; 713), the plurality of radially expandable flexible members (26; 126; 226; 326; 426; 526; 626; 726) being attached to the sheath body (13; 113; 213; 313; 413; 513; 613; 713) at a plurality of anchor points (140; 240) along the length of the sheath body (13; 113; 213; 313; 413; 513; 613; 713), wherein the plurality of radially expandable flexible members (26; 126; 226; 326; 426; 526; 626; 726) are configured to expand during active fluid inflow from the inlet to a distal end of the sheath, where the fluid flows out of the distal end and into the anatomical region of interest, and wherein the radially expandable flexible members (26; 126; 226; 326; 426; 526; 626; 726) are spaced apart along the circumference of the sheath body (13; 113; 213; 313; 413; 513; 613; 713) thereby defining one or more isolated spaces (28; 128, 144; 228; 328) that extend between the sheath body and the radially expandable flexible members (26; 126; 226; 326; 426; 526; 626; 726), respectively, when the radially expandable flexible members (26; 126; 226; 326; 426; 526; 626; 726) are inflated within a body passage and through which the fluid flows when it is supplied to the inlet, and wherein the sheath further comprises a plurality of rigid channels configured to permit fluid outflow and wherein said rigid channels extend along the length of the sheath body (13; 113; 213; 313; 413; 513; 613; 713), and wherein said rigid channels are attached to the sheath body at a plurality of anchor points, and wherein the channels of the plurality of rigid channels are spaced apart along the circumference of the sheath body thereby defining one or more isolated spaces that extend between the sheath body and the rigid channels and wherein the isolated spaces extend along the length of sheath body, and wherein said isolated spaces are configured to provide fluid flow from a distal end of the sheath body through said isolated spaces to the outflow port during active fluid outflow. a sheath body (13; 113; 213; 313; 413; 513; 613; 713) having a length; an inlet at a proximal end of the sheath body 13; 113; 213; 313; 413; 513; 613; 713); an outflow port at the proximal end of the sheath body (13; 113; 213; 313; 413; 513; 613; 713); a region including a plurality of outflow channels (32, 332, 344) which extend along the length of the sheath body (13; 113; 2013; 313; 413; 513; 613; 713) wherein the region is configured to remove debris from an anatomical region of interest during active fluid outflow; and a plurality of radially expandable flexible members (26; 126; 226; 326; 426; 526; 626; 726) which extend along the length of the sheath body (13; 113; 213; 313; 413; 513; 613; 713), the plurality of radially expandable flexible members (26; 126; 226; 326; 426; 526; 626; 726) being attached to the sheath body (13; 113; 213; 313; 413; 513; 613; 713) at a plurality of anchor points (140; 240) along the length of the sheath body (13; 113; 213; 313; 413; 513; 613; 713), wherein the plurality of radially expandable flexible members (26; 126; 226; 326; 426; 526; 626; 726) are configured to expand during active fluid inflow from the inlet to a distal end of the sheath, where the fluid flows out of the distal end and into the anatomical region of interest, and wherein the radially expandable flexible members (26; 126; 226; 326; 426; 526; 626; 726) are spaced apart along the circumference of the sheath body (13; 113; 213; 313; 413; 513; 613; 713) thereby defining one or more isolated spaces (28; 128, 144; 228; 328) that extend between the sheath body and the radially expandable flexible members (26; 126; 226; 326; 426; 526; 626; 726), respectively, when the radially expandable flexible members (26; 126; 226; 326; 426; 526; 626; 726) are inflated within a body passage and through which the fluid flows when it is supplied to the inlet, and wherein the sheath further comprises a plurality of rigid channels configured to permit fluid outflow and wherein said rigid channels extend along the length of the sheath body (13; 113; 213; 313; 413; 513; 613; 713), and wherein said rigid channels are attached to the sheath body at a plurality of anchor points, and wherein the channels of the plurality of rigid channels are spaced apart along the circumference of the sheath body thereby defining one or more isolated spaces that extend between the sheath body and the rigid channels and wherein the isolated spaces extend along the length of sheath body, and wherein said isolated spaces are configured to provide fluid flow from a distal end of the sheath body through said isolated spaces to the outflow port during active fluid outflow.