An electrosurgical tubular trocar system has a hollow tube substantially longer than its diameter. The tube is shaped for insertion in a direction generally along its axis through tissue of a human or animal body. Distal and proximal ends on the tube enter and remain outside the tissue, respectively. A tip on the distal end punctures tissue of a human or animal. An insulating portion of high dielectric material extends along the tube between the distal and proximal ends. An electrode on the insulating portion extends from the proximal end to the tip to transmit radio frequency energy. An energy supply at the electrode proximal end permits the passage of energy to the tip. An electrosurgical generator as part of the energy supply has a control to regulate the amplitude and frequency of the energy. A return path in circuit with the tip and the energy supply cuts and/or coagulates. A tip point at an acute angle to the axis lessens the initial force necessary for entry of the tube. The return path is a conductor on the insulating portion for bipolar cutting across a gap. A passage is made through the tissue. The tube may be conductive. The insulating portion may extend along the tube and be tubular. The electrode may be part of the tube when the conductor is on the insulating portion or the conductor may be part of the tube and the electrode may be on the insulating portion. The tube may be tapered from a smaller diameter at the tip and be smooth. The tip is chamfer and circular. An alternate system may have the return path as a conductive pad in contact with the tissue as a monopolar circuit. The tube may be in fluid communication for flow. A method of placing a trocar aligns an axis normal to the skin, energizes a generator, cuts electrosurgically tissue, drives the tube through the tissue, and disconnects the generator.
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