To deal with the problems associated with blind trocar insertion for conventional laparoscopy, an image-receivable and light-transmissible, optically clear trocar tip was conceived. Consultation with persons with optical engineering expertise resulted in the design of a prototype instrument for clinical testing. Results of a feasibility study conducted in 150 subjects indicate that a significant advance in the performance of laparoscopic surgery is possible with wide-scale implementation of this innovation. Video-aided continuous visual imaging during trocar insertion provides identification of distinct layers of the abdominal wall and helps ensure proper intraabdominal placement without the need for minilaparotomy or open laparoscopy.