Various methods and devices are provided for accessing a body cavity. In one embodiment, a surgical access device is provided and includes an elongate member having a proximal support member configured to rest against an external tissue surface, a flexible elongate central portion extending distally from the proximal support member and configured to extend through tissue, and an inflatable distal portion coupled to a distal end of the central portion. The distal portion is movable between an initial configuration, in which the distal portion is configured to be passed through an incision in tissue, and an inflated configuration in which the distal portion is expanded such that the central portion forms a working channel through the tissue for access to a body cavity. The distal portion can include an opening such that gas delivered to the distal portion can flow through the opening to insufflate a body cavity.