A trocar has an elongated shaft (12) and a cutting element (28) is attached to a distal end (16) of the shaft. The cutting element can be a transparent puncturing head formed integrally with the shaft, and a distal portion of the puncturing head is configured as a regular triangular pyramid having three sharpened cutting edges (36, 38 and 40). Alternatively, the cutting element can be three or four metal cutting blades (52, 54) which are attached to the distal end of the shaft. In either case, a pathway for light communication is established from the cutting element through the shaft, a portion of which is transparent. The shaft has a cavity (18), and a rigid endoscope (20) is positioned in the cavity to collect light from the distal end of the shaft. A video monitor (24) is connected to the endoscope for displaying an image of the path of advancement of the trocar.
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