A flexible instrument includes a first end portion, a second end portion opposite the first end portion, and a shaft extending from the first end portion to the second end portion along a central longitudinal axis. The shaft includes a first helical segment extending from the first end portion to the second end portion along a first helical path about the central longitudinal axis. The second helical segment extends from the first end portion to the second end portion along a second helical path about the central longitudinal axis. The first helical segment includes a first plurality of contact surfaces and the second helical segment includes a second plurality of contact surfaces such that when a torque is applied to the shaft, the first plurality of contact surfaces or the second plurality of contact surfaces bears against the other.

Described are various embodiments of a vaginal speculum. One embodiment comprises a handle portion and a tubular insertion portion mounted at an angle to the handle portion at a manipulatable end thereof. The tubular insertion portion defines a line-of-sight channel therein from the manipulatable end to a resiliently collapsable insertion tip portion of the tubular insertion portion. The resiliently collapsable insertion tip portion is manufactured of a resiliently collapsable material of sufficient flexibility to collapse under manual pressure to reduce an insertion cross-section thereof for ease of insertion, while being of sufficient resiliency to expand and resist collapse from vaginal wall pressure once inserted. Some embodiments provide for camera and/or lighting features. Vaginal speculum kits are further described, optionally having a reusable handle portion and various single-use, disposable tubular insertion portions which are connectable thereto for different anatomies, examinations and procedures.

An intravascular device for treating a fistula and methods of using the same are provided. A catheter tube extends from a handle assembly and is attached to an expandable portion which is selectively movable between a first position and an expanded position. Incising elements located at the expandable portion have tapered profiles for creating incisions in tissue accumulated at the fistula upon axial retraction through the fistula. Irrigation or suction devices may be provided.