The present invention relates to a medical device comprising: a shaft (402) including a working channel (430) extending from a proximal end of the shaft to a distal end of the shaft; an ultrasound sensor (450) disposed radially outward of a distal portion of the working channel such that the ultrasound sensor at least partially surrounds the working channel; an instrument (710) translatable from the proximal end of the shaft to the distal end of the, wherein the working channel receives the instrument and maintains an orientation of the instrument with respect to the shaft so that a distal end of the instrument has a unique radial location upon exiting the distal end of the shaft; and an area having an echogenic signature (411) distinct from a remainder of the shaft the area being provided at a distal portion of the shaft.