an elongated handle portion defining a longitudinal axis and having an outer surface defining an effective handle dimension perpendicular to said longitudinal axis that is sized for the handle portion to pass through the cannula in the direction of said longitudinal axis; and

a blade having a proximal end connected said handle, said blade having opposite transverse inner and outer edges each extending parallel to said longitudinal axis, said inner and outer edges defining a width therebetween perpendicular to said longitudinal axis that is equal to or greater than one-half the effective handle dimension and less than the effective handle dimension, said blade including a cutting edge at a distal end of said blade extending continuously from said inner edge to said outer edge, said cutting blade having a distal end that extends from said inner edge and an opposite proximal end that extends from said outer edge such that said proximal end is positioned proximal to said distal end along said longitudinal axis, said cutting edge extending across said width and configured to create an incision in skin, wherein said blade is connected to said handle so that said longitudinal axis does not intersect said cutting edge and is offset from said inner and outer edges, wherein said outer edge of said blade is offset from said outer surface of said handle perpendicular to said longitudinal axis and outside said outer surface in relation to said longitudinal axis.