A surgical access device can comprise a working channel providing a first lumen having an axial opening for insertion of a surgical instrument having an outflow channel, the first lumen having a fluid inlet for allowing fluid flow through the working channel and into the body, wherein fluid flows out of the body through the outflow channel of the surgical instrument; and a optical channel providing a second lumen for a visualization element and a light source, wherein the working channel comprises a larger cross-sectional area than the cross-sectional area of the optical channel. The surgical access device can further comprise a seal apparatus coupled to the working channel and configured to receive the surgical instrument, the seal apparatus comprising a first seal portion and a second seal portion, the first seal portion configured to close the fluid path into the seal apparatus, and the second seal portion configured to form a seal with the surgical instrument.