A surgical system includes a flexible endoscope including a lens at a distal endoscope end, a hollow shaft including a proximal shaft end and a distal shaft end, and an instrument spanning the length of the shaft. The instrument includes a handle portion adjacent the proximal shaft end and a tool portion adjacent the distal shaft end. When the endoscope is inserted into the shaft, the lens provides, adjacent the proximal shaft end, direct visualization of the change in condition of the tool portion of the instrument adjacent to the distal shaft end.
