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An arthroscopic inflow and outflow sheath providing an improved inflow and outflow system reducing the diameter of a continuous flow system while providing fluid management during arthroscopy. The improved arthroscopic inflow and outflow sheath comprises an elongated atraumatic sheath having an inne

An arthroscopic inflow and outflow sheath providing an improved inflow and outflow system reducing the diameter of a continuous flow system while providing fluid management during arthroscopy. The improved arthroscopic inflow and outflow sheath comprises an elongated atraumatic sheath having an inner surface, outer surface, proximal end, and distal end. The atraumatic sheath further comprises plurality of pleated ribs, tubes, or v-shaped ribs extending from the inner surface of the sheath and designed to contact an outer surface of the arthroscope thereby creating outer lumens facilitating the inflow and outflow of fluid to a surgical site.

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1. An atraumatic sheath comprising: a tube characterized by a wall, a distal section having a distal tip with a first diameter, a proximal section, an outer surface, an inner surface, an inner diameter and an outer diameter;wherein the inner diameter of said tube is sized and dimensioned to permit f

1. An atraumatic sheath comprising: a tube characterized by a wall, a distal section having a distal tip with a first diameter, a proximal section, an outer surface, an inner surface, an inner diameter and an outer diameter;wherein the inner diameter of said tube is sized and dimensioned to permit fluid flow between the inner surface of the tube and an outer surface of an arthroscopic instrument when the arthroscopic instrument is disposed within the tube;wherein the first diameter of the distal tip of the tube is less than an outer diameter of the arthroscopic instrument, forming a seal at the distal tip of the tube when the arthroscopic instrument is disposed within the tube;a plurality of pleated ribs extending inwardly from the inner surface of the tube and running longitudinally along the tube;wherein said pleated ribs further define lumens between the outer surface of the arthroscopic instrument and inner surface of the tube; andwherein said distal section further comprises a plurality of holes in a sidewall of the distal section of the tube said holes in fluid communication with one or more outer lumens and a surgical site. 2. The sheath of claim 1 wherein the pleated ribs are compressible. 3. An atraumatic sheath comprising: a tube characterized by a wall, a distal section having a distal tip with a first diameter, a proximal section, an outer surface, an inner surface, an inner diameter and an outer diameter;wherein the inner diameter of said tube is sized and dimensioned to permit fluid flow between the inner surface of the tube and an outer surface of an arthroscopic instrument when the arthroscopic instrument is disposed within the tube;wherein the first diameter of the distal tip of the tube is less than an outer diameter of the arthroscopic instrument, forming a seal at the distal tip of the tube when the arthroscopic instrument is disposed within the tube;a plurality of elastic tubes extending inwardly from the inner surface of the tube and running longitudinally along the tube;wherein said elastic tubes further define lumens between the outer surface of the arthroscopic instrument and inner surface of the tube; andwherein said distal section further comprises a plurality of holes in a sidewall of the distal section of the tube said holes in fluid communication with one or more outer lumens and a surgical site. 4. The sheath of claim 3 wherein the elastic tubes are compressible. 5. An atraumatic sheath comprising: a tube characterized by a wall, a distal section having a distal tip with a first diameter, a proximal section, an outer surface, an inner surface, an inner diameter and an outer diameter;wherein the inner diameter of said tube is sized and dimensioned to permit fluid flow between the inner surface of the tube and an outer surface of an arthroscopic instrument when the arthroscopic instrument is disposed within the tube;wherein the first diameter of the distal tip of the tube is less than an outer diameter of the arthroscopic instrument, forming a seal at the distal tip of the tube when the arthroscopic instrument is disposed within the tube;a plurality of v-shaped ribs extending inwardly from the inner surface of the tube and running longitudinally along the tube;wherein said v-shaped ribs further define lumens between the outer surface of the arthroscopic instrument and inner surface of the tube; andwherein said distal section further comprises a plurality of holes in a sidewall of the distal section of the tube said holes in fluid communication with one or more outer lumens and a surgical site. 6. The sheath of claim 5 wherein the v-shaped ribs are compressible.