Endoscopic instrument with secondary vacuum source

An endoscopic instrument to be used with an endoscope (18), the instrument comprising: an elongated tube having a distal end and a proximal end; an end effector attached to the distal end of the elongated tube; and a handle attached to the proximal end; including the handle means (2973) for attaching the instrument to a first vacuum source, and further including the handle a second source (2970, 3070, 3070A) integral vacuum with the handle for amplifying the first vacuum source, so that the first and second vacuum sources combine to operate the end effector.