Scalpel sheath and methods for use

The present invention provides improved devices and methods for making a small incision with a surgical scalpel through skin overlying an intercostal space to establish an access tract for the subsequent placement of minimally invasive direct cardiac massagers, chest tubes, defibrillation electrodes, and the like. A sheathed scalpel according to the present invention comprises a handle having a proximal end and a distal end, a cutting blade attached to the distal end of the handle and having a cutting edge and a tip, and a sheath attached to the handle and having a central passage configured to receive the blade. The sheath covers the blade when the blade is retracted within the central passage and exposes the cutting edge of the blade but not the tip when the blade is advanced within the central passage.