An endoscope sheath is providing comprising a sheath tube extending along a longitudinal axis between a proximal end and a distal end, the sheath tube configured to receive at least a portion of an endoscope a hub adapter connected to the sheath tube, the hub adapter including an arm configured to engage at least a portion of the endoscope so that the hub adapter and the sheath tube are restricted from rotating about the longitudinal axis and a knob configured to engage a shoulder of the endoscope and the sheath tube so that movement of the knob relative to the hub adapter moves the sheath tube axially along the longitudinal axis.
