Devices and methods for performing percutaneous surgery under direct visualization and through a single cannula are shown. A device (10) is provided which includes an elongated cannula (20) having a first inner diameter (D.sub.I) and an outer diameter (D.sub.O) sized for percutaneous introduction into a patient. The cannula (20) defines a working channel (25) between its ends (21, 22) which has a second diameter (D.sub.2) equal to the diameter (D.sub.I) of the cannula sized for receiving a tool therethrough. An elongated viewing element (50) is engageable to the cannula (20) adjacent the working channel (25), preferably by a fixture (30, 170). The fixture (30, 170) includes a housing/body (31, 171) attachable to the proximal end (22) of the cannula (20). The housing (31) defines an optics bore (60, 180) to support a viewing element (50) for translation and rotation relative to the cannula (20) so that the longitudinal axis of the optics bore (60, 180) will translate parallel to and rotate about the longitudinal axis of the working channel (25). Methods are also provided for performing surgeries percutaneously with direct visualization and without the requirement for a fluid-maintained workspace.