Abstract: A trocar has an elongated shaft, and a cutting element is attached to a distal end 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. Alternatively, the cutting element can be three or four metal cutting blades 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, and a rigid endoscope is positioned in the cavity to collect light from the distal end of the shaft. A video monitor is connected to the endoscope for displaying an image of the path of advancement of the trocar.