A medical device, comprising: - a housing having a proximal end and a distal port; - an attachment structure located within the housing and which is configured for coupling to a medical instrument; - at least one of a suction port or an irrigation port located at the proximal end of the housing and which is configured for connection to a source of suction or irrigation, respectively; - a conduit providing a fluid flow path (80 or 90) from the at least one suction port or from the at least one irrigation port to the distal port, said conduit defining a lumen along a distal portion of the conduit itself; - a valve housing chamber (64 or 66) in direct fluid communication with the distal port; and - at least one valve configured to move within the fluid flow path (80 or 90) to selectively actuate suction or irrigation, wherein the valve is configured to rotate to permit a first level of suction or irrigation and is configured to axially displace to permit a second, higher level of suction or irrigation and wherein the valve comprises a piston located within the housing chamber (64 or 66), the piston being movable between a first position blocking fluid flow along the fluid flow path and a second position allowing fluid flow along the fluid flow path, the piston including at least one aperture, and the piston being in the second position when the aperture is moved to at least partially align the aperture with the lumen; wherein the medical device further comprises: - a ramp that extends between a first limit and a second limit along an exterior surface of the valve housing chamber (64 or 66) and in that the at least one valve is configured to rotate along a path defined by the ramp to permit a first level of suction or irrigation and is configured to axially displace along a longitudinal axis of the valve housing chamber (64 or 66) to permit a second, higher level of suction or irrigation; and - an actuation button (41 or 42) engaged with said piston and including an inward protrusion that engages the ramp such that rotating the actuation button (41 or 42) between the first limit and the second limit causes at least partial alignment between the aperture and the lumen. - a housing having a proximal end and a distal port; - an attachment structure located within the housing and which is configured for coupling to a medical instrument; - at least one of a suction port or an irrigation port located at the proximal end of the housing and which is configured for connection to a source of suction or irrigation, respectively; - a conduit providing a fluid flow path (80 or 90) from the at least one suction port or from the at least one irrigation port to the distal port, said conduit defining a lumen along a distal portion of the conduit itself; - a valve housing chamber (64 or 66) in direct fluid communication with the distal port; and - at least one valve configured to move within the fluid flow path (80 or 90) to selectively actuate suction or irrigation, wherein the valve is configured to rotate to permit a first level of suction or irrigation and is configured to axially displace to permit a second, higher level of suction or irrigation and wherein the valve comprises a piston located within the housing chamber (64 or 66), the piston being movable between a first position blocking fluid flow along the fluid flow path and a second position allowing fluid flow along the fluid flow path, the piston including at least one aperture, and the piston being in the second position when the aperture is moved to at least partially align the aperture with the lumen; - a ramp that extends between a first limit and a second limit along an exterior surface of the valve housing chamber (64 or 66) and in that the at least one valve is configured to rotate along a path defined by the ramp to permit a first level of suction or irrigation and is configured to axially displace along a longitudinal axis of the valve housing chamber (64 or 66) to permit a second, higher level of suction or irrigation; and - an actuation button (41 or 42) engaged with said piston and including an inward protrusion that engages the ramp such that rotating the actuation button (41 or 42) between the first limit and the second limit causes at least partial alignment between the aperture and the lumen.