The assembly of an elongate medical device and an adaptor to orient the elongate medical device in relation to an endoscope, the adaptor comprising: a first portion having a distal end connectable and rotationally securable to the endoscope and a proximal end, the first portion having a first lumen defined longitudinally therethrough and one of an orienting key or a keyway extending longitudinally at least partially along the first portion; a second portion connectable to the first portion and including a second lumen extending longitudinally through the second portion and operably connectable to the first lumen, the second portion having the other of the key or the keyway extending longitudinally at least partially along the second portion, the keyway configured to releasably mate with the key to orient and rotationally secure the second portion relative to the first portion; and the elongate medical device comprising: a handle connectable to the second portion, the handle configured to adjust the longitudinal position of the medical device relative to the second portion; and a needle extendable distally through the endoscope, the needle comprising an echogenic surface and a tip that is orientable in relation to a distal portion of the endoscope; wherein the second portion is configured to receive the elongate medical device longitudinally movable in relation to the second portion and rotationally secured relative to the second portion; wherein the adaptor is configured to orient said needle tip relative to the endoscope, so that said needle tip is extendible from the distal portion of the endoscope in the same orientation for the first and subsequent extensions of the needle from the endoscope. a first portion having a distal end connectable and rotationally securable to the endoscope and a proximal end, the first portion having a first lumen defined longitudinally therethrough and one of an orienting key or a keyway extending longitudinally at least partially along the first portion; a second portion connectable to the first portion and including a second lumen extending longitudinally through the second portion and operably connectable to the first lumen, the second portion having the other of the key or the keyway extending longitudinally at least partially along the second portion, the keyway configured to releasably mate with the key to orient and rotationally secure the second portion relative to the first portion; and the elongate medical device comprising: a handle connectable to the second portion, the handle configured to adjust the longitudinal position of the medical device relative to the second portion; and a needle extendable distally through the endoscope, the needle comprising an echogenic surface and a tip that is orientable in relation to a distal portion of the endoscope; a handle connectable to the second portion, the handle configured to adjust the longitudinal position of the medical device relative to the second portion; and a needle extendable distally through the endoscope, the needle comprising an echogenic surface and a tip that is orientable in relation to a distal portion of the endoscope; wherein the second portion is configured to receive the elongate medical device longitudinally movable in relation to the second portion and rotationally secured relative to the second portion; wherein the adaptor is configured to orient said needle tip relative to the endoscope, so that said needle tip is extendible from the distal portion of the endoscope in the same orientation for the first and subsequent extensions of the needle from the endoscope.