A system for accessing underlying tissue, which comprises: an elongated access sheath defining a longitudinal axis a penetrating tip releasably mounted to the elongated access sheath and configured to be passed through tissue, the penetrating tip having a transparent region for direct visualization of tissue, the penetrating tip being configured to be removed through the elongated access sheath and an elongated removal member configured to be positioned within the elongated access sheath and releasably mountable to the penetrating tip to permit the elongated removal member to remove the penetrating tip through the elongated access sheath subsequent to passage of the penetrating tip through tissue.
