An advancing system, comprising: an endoscope having a proximal portion, a distal portion, a working channel extending from the proximal portion to the distal portion, an endoscope aperture disposed at the distal portion and in communication with the working channel, and a port disposed at the proximal portion and in communication with the working channel; and an endoscope sheath having a first lumen extending from a first proximal end to a first distal end, wherein the endoscope is disposed through the first lumen, a second lumen extending from a second proximal end to a second distal end and configured to receive an elongate medical device, and a first aperture and a second aperture in fluid communication with the second lumen, wherein the first aperture is disposed at the second proximal end of the second lumen, wherein the second aperture is disposed at the second distal end of the second lumen, and wherein the second aperture is spaced proximally of a distal end of the endoscope; the advancing system further comprising an endoscope cap which comprises a first coupling member mated with the second lumen at the second distal end: characterised in that: the first coupling member comprises: a first coupling member proximal portion and a first coupling member distal portion; and a first coupling member lumen extending from the first coupling member proximal portion to the first coupling member distal portion, the first coupling member lumen open at both ends, wherein the first coupling member lumen is configured to receive the elongate medical device; and in that: the endoscope cap comprises a non-movable ramp configured to deflect an elongate medical device received through the first coupling member. an endoscope having a proximal portion, a distal portion, a working channel extending from the proximal portion to the distal portion, an endoscope aperture disposed at the distal portion and in communication with the working channel, and a port disposed at the proximal portion and in communication with the working channel; and an endoscope sheath having a first lumen extending from a first proximal end to a first distal end, wherein the endoscope is disposed through the first lumen, a second lumen extending from a second proximal end to a second distal end and configured to receive an elongate medical device, and a first aperture and a second aperture in fluid communication with the second lumen, characterised in that: the first coupling member comprises: a first coupling member proximal portion and a first coupling member distal portion; and a first coupling member lumen extending from the first coupling member proximal portion to the first coupling member distal portion, the first coupling member lumen open at both ends, wherein the first coupling member lumen is configured to receive the elongate medical device; and in that: the endoscope cap comprises a non-movable ramp configured to deflect an elongate medical device received through the first coupling member. the first coupling member comprises: a first coupling member proximal portion and a first coupling member distal portion; and a first coupling member lumen extending from the first coupling member proximal portion to the first coupling member distal portion, the first coupling member lumen open at both ends, wherein the first coupling member lumen is configured to receive the elongate medical device; and in that: the endoscope cap comprises a non-movable ramp configured to deflect an elongate medical device received through the first coupling member. a first coupling member proximal portion and a first coupling member distal portion; and a first coupling member lumen extending from the first coupling member proximal portion to the first coupling member distal portion, the first coupling member lumen open at both ends, wherein the first coupling member lumen is configured to receive the elongate medical device; and in that: the endoscope cap comprises a non-movable ramp configured to deflect an elongate medical device received through the first coupling member. the endoscope cap comprises a non-movable ramp configured to deflect an elongate medical device received through the first coupling member.