Patent ID: 8460178

Claim:
A method of managing a distending medium during an endoscopic procedure, comprising: providing a flexible tubular sheath having a proximal end and a distal end, the flexible tubular sheath consisting of a flexible double-wall cylindrical structure formed of walls that are all flexible, the flexible walls defining a closed, flexible cavity, the closed, flexible cavity being permanently filled and consisting of a constant, predetermined volume of fluid and having a uniform inner diameter throughout its length; subsequently, installing the entire flexible tubular sheath over a limited longitudinal portion of an endoscopic instrument, so that the entire flexible tubular sheath surrounds and is in contact with a specific location of the endoscopic instrument; and after the step of installing the entire flexible tubular sheath over the limited longitudinal portion of the endoscopic instrument, introducing the endoscopic instrument together with the installed flexible tubular sheath into a body cavity through an incision in a wall of the body cavity and through a rolling motion, so that the flexible tubular sheath is partially inserted into the body cavity during the endoscopic procedure to allow insertion of additional instruments through it, and so that outer and inner surfaces of the flexible double-wall cylindrical structure interchange their position by rolling motion and the distal end of the flexible tubular sheath inside the body cavity acquires a bell shape, to prevent leakage of the distending medium from the body cavity through the incision, wherein only a limited portion of the flexible tubular sheath that is in close proximity to the distal end is in contact with the wall of the body cavity and wherein a length of the said limited portion is equal to the wall thickness of the body cavity.