The transmission of infectious diseases is a constant risk in hospitals. Invasive instruments such as endoscopes pose a particular risk in this regard. Due to their complex structure, flexible endoscopes are especially difficult to clean and disinfect and present a particular challenge in manufacturing and assembly. We investigate three innovative methods for manufacturing complex moving components within flexible endoscopes. The methods investigated are extrusion-based silicone 3D printing to enclose the endoscope’s internal components, stereolithography to print a flexible rib structure, start and end pieces as well as a mold, and silicone casting to embed the printed rib structure. The development of the different manufacturing processes and respective new biologically inspired design approaches culminated in the creation of three demonstrators, which were evaluated regarding their mechanical flexibility and overall compliance with the requirements for the reference endoscope.