An inflow access cannula system for allowing an instrument to access a remote surgical site, wherein the instrument comprises a distal portion having a smaller diameter and a proximal portion having a larger diameter, the system comprising:an inflow access cannula comprising a distal end, a proximal end and a central lumen extending therebetween, wherein the central lumen has a diameter larger than the distal portion of the instrument and smaller than the proximal portion of the instrument; andan instrument adapter for releasable connection to the inflow access cannula, the instrument adapter comprising a lumen communicating with the central lumen of the inflow access cannula, the lumen having a diameter larger than the proximal portion of the instrument, the instrument adapter further comprising a port and a fluid passageway connecting the port with the lumen of the instrument adapter, and a spacer for spacing the proximal portion of the instrument from the distal end of the inflow access cannula, such that when an instrument is disposed in the inflow access cannula system so that the distal portion of the instrument extends within the central lumen of the inflow access cannula and the proximal portion of the instrument is disposed in the central lumen of the instrument adapter and is in engagement with the spacer, fluid can flow into the port of the instrument adapter, along the fluid passageway of the instrument adapter, into the lumen of the instrument adapter and through the lumen of the inflow access cannula.