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endoscopic Vision will be difficult or impossible when there is a large backflow of irrigating flu through the hole of the Rubber seal of the nephroscope operating Channel another Rubber seal with a small hole is not available the Piston of a 20 ml syringe is removed and the rubber piston head is disassembled the middle disc is harvested with cissors the small rubber disc is inserted in the nephroscope Rubber seal it is punctured in the middle and delated with the 12 fren delator to allow the introduction of instruments there is no longer any backflow of irrigating flu even with the manual pressure on the serum bag