Abstract: Apparatus and methods of effecting a medical procedure, e.g., laparoscopic, endoscopic, etc. procedures, through a small percutaneous incision or puncture in the body of a patient. One embodiment of the apparatus comprises an elongated outer tube, an elongated inner tube located within the outer tube and moveable relative thereto. An electrosurge electrode is mounted on the distal end of the inner tube so that it can be moved to a retracted position when it is not need or to an extended position when it is to be use. A vacuum system and an irrigation system are provided. The vacuum system is arranged to apply suction through an annular space between the tubes to effect the removal of tissue or other debris from the operative site within the patients body. The irrigation system is arranged to supply an irrigation liquid through the inner tube to the operative site. Each of the tubes is formed of an electrically insulating material so that the apparatus can be safely inserted within the patient's body.